Healthcare Provider Details

I. General information

NPI: 1932697273
Provider Name (Legal Business Name): GLENDA ZAMORA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9121 N MILITARY TRL STE 102
PALM BEACH GARDENS FL
33410-5985
US

IV. Provider business mailing address

9121 N MILITARY TRL STE 102
PALM BEACH GARDENS FL
33410-5985
US

V. Phone/Fax

Practice location:
  • Phone: 561-619-2460
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS19101
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: