Healthcare Provider Details

I. General information

NPI: 1881663466
Provider Name (Legal Business Name): ZAPA MANAGEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6271-17 ST AUGUSTINE RD
JACKSONVILLE FL
32217
US

IV. Provider business mailing address

6271-17 ST AUGUSTINE RD
JACKSONVILLE FL
32217
US

V. Phone/Fax

Practice location:
  • Phone: 904-425-6991
  • Fax: 904-425-6987
Mailing address:
  • Phone: 904-425-6991
  • Fax: 904-425-6987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberAHCA9043
License Number StateFL

VIII. Authorized Official

Name: MR. ZINOVIY GEREVITS
Title or Position: OWNER
Credential:
Phone: 904-425-6991