Healthcare Provider Details

I. General information

NPI: 1932425600
Provider Name (Legal Business Name): MR. JAMES THOMAS ZEMBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 04/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124B S AMELIA AVE
DELAND FL
32724-5515
US

IV. Provider business mailing address

124B S AMELIA AVE
DELAND FL
32724-5515
US

V. Phone/Fax

Practice location:
  • Phone: 386-736-3322
  • Fax: 386-736-1133
Mailing address:
  • Phone: 386-736-3322
  • Fax: 386-736-1133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS2658
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: