Healthcare Provider Details

I. General information

NPI: 1073434494
Provider Name (Legal Business Name): ZENDATHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 SW 30TH PL
FORT LAUDERDALE FL
33315-2733
US

IV. Provider business mailing address

1503 SW 30TH PL
FORT LAUDERDALE FL
33315-2733
US

V. Phone/Fax

Practice location:
  • Phone: 754-444-8372
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA M GRULLON
Title or Position: OWNER
Credential: LMFT
Phone: 754-444-8372