Healthcare Provider Details

I. General information

NPI: 1639245921
Provider Name (Legal Business Name): JESSENIA ZAPATA-PALMER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 01/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 S DILLARD ST
WINTER GARDEN FL
34787-3903
US

IV. Provider business mailing address

4490 MARSH HARBOR DR
TAVARES FL
32778-4752
US

V. Phone/Fax

Practice location:
  • Phone: 407-905-0531
  • Fax: 407-905-0532
Mailing address:
  • Phone: 407-461-0477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT10211
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: