Healthcare Provider Details

I. General information

NPI: 1730477316
Provider Name (Legal Business Name): EMILY JASTER ZELENKA PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY JASTER FEITEN

II. Dates (important events)

Enumeration Date: 07/15/2011
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9611 W BROWARD BLVD
PLANTATION FL
33324-2334
US

IV. Provider business mailing address

9611 W BROWARD BLVD
PLANTATION FL
33324-2334
US

V. Phone/Fax

Practice location:
  • Phone: 954-924-7000
  • Fax:
Mailing address:
  • Phone: 954-424-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number3247
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9116339
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9116339
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: