Healthcare Provider Details

I. General information

NPI: 1255250346
Provider Name (Legal Business Name): CARLOS RICARDO ZAMBRANO BOWEN RPSGT, RST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13928 SW 102ND TER
MIAMI FL
33186-7304
US

IV. Provider business mailing address

13928 SW 102ND TER
MIAMI FL
33186-7304
US

V. Phone/Fax

Practice location:
  • Phone: 786-261-3331
  • Fax: 786-409-2414
Mailing address:
  • Phone: 786-261-3331
  • Fax: 786-409-2414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: