Healthcare Provider Details

I. General information

NPI: 1790697134
Provider Name (Legal Business Name): WINONA ZAPATA
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 BAYOU BLVD STE 26
PENSACOLA FL
32503-2671
US

IV. Provider business mailing address

4300 BAYOU BLVD STE 26
PENSACOLA FL
32503-2671
US

V. Phone/Fax

Practice location:
  • Phone: 850-725-5563
  • Fax: 850-331-6656
Mailing address:
  • Phone: 850-725-5563
  • Fax: 850-331-6656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW23944.
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: