MEDICARE: FAITH ZENCHENKO M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst
2	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1033511506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAITH ZENCHENKO M.S.

Provider Business Mailing Address
First Line	:	5224 STATION WAY
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34233-3232
Country	:	US
Telephone Number	:	941-248-5479
Fax Number	:

Provider Business Practice Location Address
First Line	:	8245 VICELA DR
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34240-1462
Country	:	US
Telephone Number	:	239-778-7490
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2014
Last Update Date	:	07/03/2025

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