Healthcare Provider Details

I. General information

NPI: 1144643958
Provider Name (Legal Business Name): DIANA ZARREKE PT, DPT, GCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 01/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W AZEELE ST
TAMPA FL
33606-2210
US

IV. Provider business mailing address

800 W AZEELE ST
TAMPA FL
33606-2210
US

V. Phone/Fax

Practice location:
  • Phone: 813-251-0370
  • Fax:
Mailing address:
  • Phone: 813-251-0370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT008090
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: