Healthcare Provider Details

I. General information

NPI: 1477416600
Provider Name (Legal Business Name): ROBERT ZUKOWSKI LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 N ANDREWS AVE APT 10J
FORT LAUDERDALE FL
33311-3905
US

IV. Provider business mailing address

1800 N ANDREWS AVE APT 10J
FORT LAUDERDALE FL
33311-3905
US

V. Phone/Fax

Practice location:
  • Phone: 646-483-8521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA96375
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: