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NPI Code Detail

MEDICARE: ZUL HERNANDEZ ATC

MEDICARE: ZUL HERNANDEZ ATC
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
12255A2300XAthletic Trainer1405SC

General Provider Information

NPI Number : 1417354754
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZUL HERNANDEZ ATC
Provider Business Mailing Address
First Line : 9200 UNIVERSITY BLVD # 118087
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9121
Country : US
Telephone Number : 352-267-3267
Fax Number :
Provider Business Practice Location Address
First Line : 9200 UNIVERSITY BLVD
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9121
Country : US
Telephone Number : 352-267-3267
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2014
Last Update Date : 12/02/2014

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Directions to “ ZUL HERNANDEZ ATC” Practice Location

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