Healthcare Provider Details

I. General information

NPI: 1952906802
Provider Name (Legal Business Name): JOHN ZAPATA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8695 CORAL WAY
MIAMI FL
33155-2337
US

IV. Provider business mailing address

2075 SW 122ND AVE APT 230
MIAMI FL
33175-7337
US

V. Phone/Fax

Practice location:
  • Phone: 305-264-4811
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS56995
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: