Healthcare Provider Details

I. General information

NPI: 1407284466
Provider Name (Legal Business Name): LINCOLN ZURITA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2013
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4831 ALVARADO DR
TAMPA FL
33634-6239
US

IV. Provider business mailing address

PO BOX 261421
TAMPA FL
33685-1421
US

V. Phone/Fax

Practice location:
  • Phone: 855-378-4610
  • Fax: 888-724-1478
Mailing address:
  • Phone: 855-378-4610
  • Fax: 888-724-1478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: