Healthcare Provider Details

I. General information

NPI: 1386807311
Provider Name (Legal Business Name): JOAQUIN FERNANDO ZALACAIN MD, FAAEM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 02/15/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 45TH ST
WEST PALM BEACH FL
33407-2047
US

IV. Provider business mailing address

216 SEDONA WAY
PALM BEACH GARDENS FL
33418-1714
US

V. Phone/Fax

Practice location:
  • Phone: 787-565-3951
  • Fax:
Mailing address:
  • Phone: 787-565-3951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number18221
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberP8329
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME128253
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: