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General NPI Number Information
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NPI Number | 1013600048
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Entity Type | Organization
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Legal Business Name | DR ZAMBRANA PRIMARY CARE CLINIC INC
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Dates
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Enumeration Date | 05/26/2023
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 11223 N WILLIAMS ST STE I
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City | DUNNELLON
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State | FL
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Zip | 34432-8307
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Country | US
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Telephone | 352-418-0802
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Fax | 352-418-0877
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Provider Business Mailing Address
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Address Line | 11223 N WILLIAMS ST STE I
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City | DUNNELLON
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State | FL
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Zip | 34432-8307
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Country | US
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Telephone | 352-421-8498
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ALEXANDER MALDONADO
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Credential |
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Telephone | 352-421-8498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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