Healthcare Provider Details

I. General information

NPI: 1346699261
Provider Name (Legal Business Name): YOVANKA ZAPATA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2016
Last Update Date: 06/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5856 WINDRIGDE DR.
WINTER HAVEN FL
33881
US

IV. Provider business mailing address

5856 WINDRIGDE DR.
WINTER HAVEN FL
33881
US

V. Phone/Fax

Practice location:
  • Phone: 863-410-4461
  • Fax:
Mailing address:
  • Phone: 863-410-4461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number16365
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: