Healthcare Provider Details

I. General information

NPI: 1942515291
Provider Name (Legal Business Name): PAMELA ZOMERFELD M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16610 SW 77TH CT
PALMETTO BAY FL
33157-3770
US

IV. Provider business mailing address

16610 SW 77TH CT
PALMETTO BAY FL
33157-3770
US

V. Phone/Fax

Practice location:
  • Phone: 305-238-0810
  • Fax: 305-238-0810
Mailing address:
  • Phone: 305-238-0810
  • Fax: 305-238-0810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA1383
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: