Healthcare Provider Details

I. General information

NPI: 1669480802
Provider Name (Legal Business Name): CARLOS ALFREDO ZAPATA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CARLOS ALFREDO ZAPATA MD

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 10/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2173 CENTERVILLE PL STE B
TALLAHASSEE FL
32308-8303
US

IV. Provider business mailing address

2173 CENTERVILLE PL STE B
TALLAHASSEE FL
32308-8303
US

V. Phone/Fax

Practice location:
  • Phone: 850-878-2113
  • Fax: 850-878-2839
Mailing address:
  • Phone: 850-878-2113
  • Fax: 850-878-2839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME37183
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: