Healthcare Provider Details

I. General information

NPI: 1518561588
Provider Name (Legal Business Name): ZACHARY PAUL ZINER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S MAIN ST
BELLE GLADE FL
33430-3423
US

IV. Provider business mailing address

645 AMADOR LN UNIT 1
WEST PALM BEACH FL
33401-8303
US

V. Phone/Fax

Practice location:
  • Phone: 561-996-7707
  • Fax:
Mailing address:
  • Phone: 941-661-9530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS55165
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: