Healthcare Provider Details

I. General information

NPI: 1033006820
Provider Name (Legal Business Name): BROCHA ZAKUTINSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 PENINSULA CORPORATE CIR
BOCA RATON FL
33487-1378
US

IV. Provider business mailing address

7587 SOLIMAR CIR
BOCA RATON FL
33433-1034
US

V. Phone/Fax

Practice location:
  • Phone: 347-217-2781
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number052590
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT44820
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: