Healthcare Provider Details

I. General information

NPI: 1619348026
Provider Name (Legal Business Name): MARLENE C ZINK RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2015
Last Update Date: 10/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 S KANNER HWY
STUART FL
34994-7204
US

IV. Provider business mailing address

3010 SW SOLITAIRE PALM DR
PALM CITY FL
34990-6302
US

V. Phone/Fax

Practice location:
  • Phone: 772-286-6260
  • Fax: 772-286-6912
Mailing address:
  • Phone: 772-215-1222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND 7333
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: