Healthcare Provider Details

I. General information

NPI: 1306771209
Provider Name (Legal Business Name): MICHAEL VICKO ZOLONDEK LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12175 PHILIPS HWY APT 5306
JACKSONVILLE FL
32256-2021
US

IV. Provider business mailing address

12175 PHILIPS HWY APT 5306
JACKSONVILLE FL
32256-2021
US

V. Phone/Fax

Practice location:
  • Phone: 352-514-9763
  • Fax:
Mailing address:
  • Phone: 352-514-9763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27904
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: