Healthcare Provider Details

I. General information

NPI: 1396057204
Provider Name (Legal Business Name): GERLANDO ZAMBUTO DC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 04/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 NE 49TH ST
FORT LAUDERDALE FL
33308-4524
US

IV. Provider business mailing address

2040 NE 49TH ST
FORT LAUDERDALE FL
33308-4524
US

V. Phone/Fax

Practice location:
  • Phone: 954-493-8875
  • Fax: 954-493-8876
Mailing address:
  • Phone: 954-493-8875
  • Fax: 954-493-8876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number23765
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH8668
License Number StateFL

VIII. Authorized Official

Name: DR. GERLANDO ZAMBUTO
Title or Position: SOLE PROPRIETOR
Credential: D.C.
Phone: 954-493-8875