Healthcare Provider Details
I. General information
NPI: 1407045685
Provider Name (Legal Business Name): JAMES S ZUCCARO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/23/2007
Last Update Date: 11/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5860 RED BUG LAKE RD
WINTER SPRINGS FL
32708-5011
US
IV. Provider business mailing address
5860 RED BUG LAKE RD
WINTER SPRINGS FL
32708-5011
US
V. Phone/Fax
- Phone: 407-790-4745
- Fax: 321-203-2523
- Phone: 407-790-4745
- Fax: 321-203-2523
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | CH12443N |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: