Healthcare Provider Details

I. General information

NPI: 1124335419
Provider Name (Legal Business Name): MR. SANDY ZAPIRAIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MS. AGNES RODRIGUEZ

II. Dates (important events)

Enumeration Date: 09/08/2010
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 NW 74TH AVE STE 105
MIAMI FL
33166-5507
US

IV. Provider business mailing address

5050 NW 74TH AVE STE 105
MIAMI FL
33166-5507
US

V. Phone/Fax

Practice location:
  • Phone: 786-333-6558
  • Fax:
Mailing address:
  • Phone: 786-333-6558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: