Healthcare Provider Details

I. General information

NPI: 1235043738
Provider Name (Legal Business Name): ANDREINA G ZAMBRANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3074 NE 49TH ST
FORT LAUDERDALE FL
33308-4915
US

IV. Provider business mailing address

3074 NE 49TH ST
FORT LAUDERDALE FL
33308-4915
US

V. Phone/Fax

Practice location:
  • Phone: 754-270-3366
  • Fax:
Mailing address:
  • Phone: 754-270-3366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11051175
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: