Healthcare Provider Details
I. General information
NPI: 1528848488
Provider Name (Legal Business Name): LOVEMORE ZINHEMA APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/28/2023
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 LAKELAND HILLS BLVD
LAKELAND FL
33805-3019
US
IV. Provider business mailing address
1600 LAKELAND HILLS BLVD
LAKELAND FL
33805-3065
US
V. Phone/Fax
- Phone: 863-680-7190
- Fax: 866-264-8519
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | APRN11025006 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: