Healthcare Provider Details

I. General information

NPI: 1407398324
Provider Name (Legal Business Name): ZOTHEKA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2038 HAWKS VIEW DR
RUSKIN FL
33570-8011
US

IV. Provider business mailing address

2038 HAWKS VIEW DR
RUSKIN FL
33570-8011
US

V. Phone/Fax

Practice location:
  • Phone: 813-421-2602
  • Fax:
Mailing address:
  • Phone: 813-421-2602
  • Fax: 239-303-7117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARCHELLE RACHEL
Title or Position: OWNER
Credential: DPT
Phone: 754-234-5319