Healthcare Provider Details

I. General information

NPI: 1962583690
Provider Name (Legal Business Name): DEBORAH R. ZARAJCZYK, MA AND ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 HAND AVE STE M
ORMOND BEACH FL
32174-8194
US

IV. Provider business mailing address

1400 HAND AVE STE M
ORMOND BEACH FL
32174-8194
US

V. Phone/Fax

Practice location:
  • Phone: 386-673-5280
  • Fax: 386-673-8618
Mailing address:
  • Phone: 386-673-5280
  • Fax: 386-673-8618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAY494
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS3954
License Number StateFL

VIII. Authorized Official

Name: DEBORAH ZARAJCZYK
Title or Position: PRESIDENT
Credential: CCC/A
Phone: 386-673-5280