Healthcare Provider Details

I. General information

NPI: 1659299949
Provider Name (Legal Business Name): ANTHONY HENRY ZAMORA MS, RDN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 WILLOUGHBY AVE APT 3
BROOKLYN NY
11237-2773
US

IV. Provider business mailing address

4926 SW 143RD CT
MIAMI FL
33175-5063
US

V. Phone/Fax

Practice location:
  • Phone: 305-632-7493
  • Fax:
Mailing address:
  • Phone: 305-632-7493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86359463
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: