Healthcare Provider Details

I. General information

NPI: 1285693523
Provider Name (Legal Business Name): SANDRA ZANETTI OTRL CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 APOLLO BLVD
MELBOURNE FL
32901
US

IV. Provider business mailing address

931 GEORGE ST
SEBASTIAN FL
32958
US

V. Phone/Fax

Practice location:
  • Phone: 321-674-5035
  • Fax: 321-674-5039
Mailing address:
  • Phone: 772-581-7625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT0005702
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: