Healthcare Provider Details

I. General information

NPI: 1003309634
Provider Name (Legal Business Name): CHRISTOFER PAUL ZAPATA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2018
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 N SYKES CREEK PKWY STE 301
MERRITT ISLAND FL
32953-3490
US

IV. Provider business mailing address

3300 S FISKE BLVD
ROCKLEDGE FL
32955-4306
US

V. Phone/Fax

Practice location:
  • Phone: 321-361-5539
  • Fax: 321-361-5543
Mailing address:
  • Phone: 321-361-5539
  • Fax: 321-361-5543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number54098
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME158442
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: