Healthcare Provider Details

I. General information

NPI: 1134409741
Provider Name (Legal Business Name): JENNY ZAVARSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2011
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12401 ORANGE DR SUITE 219
DAVIE FL
33330-4341
US

IV. Provider business mailing address

18574 SW 47TH CT
MIRAMAR FL
33029-6222
US

V. Phone/Fax

Practice location:
  • Phone: 954-862-1707
  • Fax:
Mailing address:
  • Phone: 754-367-2614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: