Healthcare Provider Details

I. General information

NPI: 1619888021
Provider Name (Legal Business Name): ZACHARY ALLY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10483 HELEY ST
SPRING HILL FL
34608-3729
US

IV. Provider business mailing address

10483 HELEY ST
SPRING HILL FL
34608-3729
US

V. Phone/Fax

Practice location:
  • Phone: 813-793-4663
  • Fax:
Mailing address:
  • Phone: 727-237-6598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2835529
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: