Healthcare Provider Details

I. General information

NPI: 1528078904
Provider Name (Legal Business Name): GLORIA ISABEL ZAPATA PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7208 MASSACHUSETTS AVE
NEW PORT RICHEY FL
34653-2934
US

IV. Provider business mailing address

7261 SYLVAN GLADE CT
WEEKI WACHEE FL
34607-4037
US

V. Phone/Fax

Practice location:
  • Phone: 727-457-2090
  • Fax: 727-842-2236
Mailing address:
  • Phone: 352-596-7312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT 12434
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: