Healthcare Provider Details

I. General information

NPI: 1417616939
Provider Name (Legal Business Name): ZOLTAN HEPP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2021
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5419 1ST ST
SAINT AUGUSTINE FL
32080-7347
US

IV. Provider business mailing address

4547 28TH PL SW
NAPLES FL
34116-7839
US

V. Phone/Fax

Practice location:
  • Phone: 239-601-5714
  • Fax:
Mailing address:
  • Phone: 239-601-5714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: