Healthcare Provider Details

I. General information

NPI: 1114205861
Provider Name (Legal Business Name): SARAH JANE ZUNIGA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. SARAH JANE NERY VALENZUELA

II. Dates (important events)

Enumeration Date: 07/29/2011
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-6413
  • Fax:
Mailing address:
  • Phone: 407-303-6413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR177359
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13305
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11024363
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: