Healthcare Provider Details

I. General information

NPI: 1356853360
Provider Name (Legal Business Name): TRACY ZAPANTA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2017
Last Update Date: 01/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 MALABAR RD
MALABAR FL
32950-3120
US

IV. Provider business mailing address

PO BOX 1137
MELBOURNE FL
32902-1137
US

V. Phone/Fax

Practice location:
  • Phone: 321-722-8435
  • Fax: 321-722-8486
Mailing address:
  • Phone: 321-952-9696
  • Fax: 321-952-7937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9283548
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: