Healthcare Provider Details

I. General information

NPI: 1699938399
Provider Name (Legal Business Name): NORA ZAPATA P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5409 N STATE ROAD 7
TAMARAC FL
33319-2921
US

IV. Provider business mailing address

5409 N STATE ROAD 7
TAMARAC FL
33319-2921
US

V. Phone/Fax

Practice location:
  • Phone: 954-733-3339
  • Fax:
Mailing address:
  • Phone: 954-733-3339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9100209
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: