Healthcare Provider Details

I. General information

NPI: 1982919163
Provider Name (Legal Business Name): ZDENKA ROTHENBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2010
Last Update Date: 08/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7009 SAN SEBASTIAN CIR
BOCA RATON FL
33433-1056
US

IV. Provider business mailing address

7009 SAN SEBASTIAN CIR
BOCA RATON FL
33433-1056
US

V. Phone/Fax

Practice location:
  • Phone: 561-213-6348
  • Fax: 561-258-8180
Mailing address:
  • Phone: 561-213-6348
  • Fax: 561-258-8180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP2843
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: