Healthcare Provider Details

I. General information

NPI: 1023474046
Provider Name (Legal Business Name): DANIEL HERNANDO ZAMBRANO M.S., PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2016
Last Update Date: 01/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3855 NW 15TH AVE
GAINESVILLE FL
32605-4628
US

IV. Provider business mailing address

1225 CENTER DR PO BOX 100496
GAINESVILLE FL
32610-3007
US

V. Phone/Fax

Practice location:
  • Phone: 352-359-0296
  • Fax:
Mailing address:
  • Phone: 352-273-6263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License NumberPS54501
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: