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General NPI Number Information
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NPI Number | 1326758293
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Entity Type | Individual
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Provider Name | JOSE ZALDIVAR RICARDO APRN
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Gender | Male
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Dates
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Enumeration Date | 12/01/2022
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 8726 W WATERS AVE
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City | TAMPA
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State | FL
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Zip | 33615-1714
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Country | US
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Telephone | 813-712-1726
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Fax | 813-925-4640
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Provider Business Mailing Address
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Address Line | 4709 ONYX PL
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City | TAMPA
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State | FL
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Zip | 33615-4923
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Country | US
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Telephone | 813-723-0546
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11023190
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License Number State | FL
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