Healthcare Provider Details

I. General information

NPI: 1134645179
Provider Name (Legal Business Name): MIRIAM ELIZABETH ZAPATA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MIRIAM ELIZABETH BRICENO RN

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 07/21/2022
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13767 AMELIA POND DRIVE
WINDERMERE FL
34786
US

IV. Provider business mailing address

2306 NORTH BLVD W STE C
DAVENPORT FL
33837-8976
US

V. Phone/Fax

Practice location:
  • Phone: 305-731-0223
  • Fax:
Mailing address:
  • Phone: 305-731-0223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2543932
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: