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General NPI Number Information
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NPI Number | 1528271780
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Entity Type | Individual
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Provider Name | PAUL DAVID ZETTEROWER ARNP
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Gender | Male
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 3625 UNIVERSITY BLVD S
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4207
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Country | US
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Telephone | 904-399-6190
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Fax |
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Provider Business Mailing Address
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Address Line | 7244 SAN JOSE BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32217-3426
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Country | US
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Telephone | 904-327-1423
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | ARNP9234772
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License Number State | FL
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