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General NPI Number Information
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NPI Number | 1326263443
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Entity Type | Individual
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Provider Name | SHARON R ZACK LMT
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Gender | Female
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 851 W STATE ROAD 436 SUITE 1061
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-3000
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Country | US
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Telephone | 321-277-7054
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Fax | 352-357-7200
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Provider Business Mailing Address
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Address Line | 13939 WELLINGTON LN
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City | GRAND ISLAND
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State | FL
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Zip | 32735-9121
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Country | US
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Telephone | 321-277-7054
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Fax | 352-357-7200
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA 43428
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License Number State | FL
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