Healthcare Provider Details

I. General information

NPI: 1922977560
Provider Name (Legal Business Name): ZAKIA FREDERICK APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

4853 E IRLO BRONSON MEMORIAL HWY # 1047
SAINT CLOUD FL
34771-8722
US

V. Phone/Fax

Practice location:
  • Phone: 689-334-2569
  • Fax:
Mailing address:
  • Phone: 689-334-2569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11045573
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9513653
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: