Healthcare Provider Details

I. General information

NPI: 1104413038
Provider Name (Legal Business Name): GIOVANNY ZAPATA MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2020
Last Update Date: 12/27/2020
Certification Date: 12/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24153 SW 107TH CT
HOMESTEAD FL
33032-5168
US

IV. Provider business mailing address

24153 SW 107TH CT
HOMESTEAD FL
33032-5168
US

V. Phone/Fax

Practice location:
  • Phone: 786-200-0037
  • Fax:
Mailing address:
  • Phone: 786-200-0037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11010546
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: