Healthcare Provider Details

I. General information

NPI: 1104786144
Provider Name (Legal Business Name): FAMILY WELLNESS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 MAGUIRE RD UNIT A
OCOEE FL
34761-4755
US

IV. Provider business mailing address

2960 MAGUIRE RD UNIT B
OCOEE FL
34761-4755
US

V. Phone/Fax

Practice location:
  • Phone: 407-347-7267
  • Fax: 321-256-5349
Mailing address:
  • Phone: 407-347-7267
  • Fax: 321-256-5349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MIRIAM ELIZABETH ZAPATA
Title or Position: NURSE PRACTITIONER/ ADMINISTRATOR
Credential: NP
Phone: 305-731-0223