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General NPI Number Information
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NPI Number | 1003638750
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Entity Type | Individual
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Provider Name | CARLOS ZAPATA HENAO DMD
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Gender | Male
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 1993 DANIELS RD STE 120
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City | WINTER GARDEN
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State | FL
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Zip | 34787-4598
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Country | US
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Telephone | 407-863-0476
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Fax |
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Provider Business Mailing Address
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Address Line | 13512 LODI TER APT 5209
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City | WINDERMERE
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State | FL
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Zip | 34786-7449
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Country | US
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Telephone | 954-249-0274
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 29356
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 29356
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License Number State | FL
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