Healthcare Provider Details

I. General information

NPI: 1578542429
Provider Name (Legal Business Name): ROBERT ZYKOSKI R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3912 S OCEAN BLVD #1407
HIGHLAND BEACH FL
33487-3338
US

IV. Provider business mailing address

3912 S OCEAN BLVD #1407
HIGHLAND BEACH FL
33487-3338
US

V. Phone/Fax

Practice location:
  • Phone: 561-441-1410
  • Fax:
Mailing address:
  • Phone: 561-441-1410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS25258
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: