Healthcare Provider Details

I. General information

NPI: 1750328316
Provider Name (Legal Business Name): ANDRES ZAPATA O.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 05/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7878 NW 52ND ST
DORAL FL
33166-4742
US

IV. Provider business mailing address

7878 NW 52ND ST
DORAL FL
33166-4742
US

V. Phone/Fax

Practice location:
  • Phone: 305-244-5883
  • Fax: 305-675-2755
Mailing address:
  • Phone: 305-244-5883
  • Fax: 305-675-2755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT11471
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: