Healthcare Provider Details

I. General information

NPI: 1457066672
Provider Name (Legal Business Name): MR. ISAIAH MANUEL ZAPATA I
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 NAPOLEON RD APT B14
BOWLING GREEN OH
43402-4631
US

IV. Provider business mailing address

300 NAPOLEON RD APT B14
BOWLING GREEN OH
43402-4631
US

V. Phone/Fax

Practice location:
  • Phone: 419-378-8624
  • Fax:
Mailing address:
  • Phone: 419-378-8624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: