Healthcare Provider Details

I. General information

NPI: 1609321926
Provider Name (Legal Business Name): LUZ ZAPATA-NEGRON MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6210 W COLONIAL DR STE 116
ORLANDO FL
32808-7504
US

IV. Provider business mailing address

6210 W COLONIAL DR STE 116
ORLANDO FL
32808-7504
US

V. Phone/Fax

Practice location:
  • Phone: 407-325-4577
  • Fax:
Mailing address:
  • Phone: 407-325-4577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA28687
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: