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NPI 1962409193

NPI 1962409193 : JORGE ZARATE M.D. : NORFOLK, VA

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General NPI Number Information
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    NPI Number           |    1962409193
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    Entity Type          |    Individual 
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    Provider Name        |    JORGE ZARATE M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/01/2005
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    Last Update Date     |    03/22/2019
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Provider Practice Location Address
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    Address Line         |    830 KEMPSVILLE RD 
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    City                 |    NORFOLK
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    State                |    VA
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    Zip                  |    23502-3920
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    Country              |    US
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    Telephone            |    757-967-8622
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    Fax                  |    757-686-0541
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Provider Business Mailing Address
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    Address Line         |    3241 WESTERN BRANCH BLVD 
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    City                 |    CHESAPEAKE
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    State                |    VA
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    Zip                  |    23321-5260
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    Country              |    US
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    Telephone            |    757-686-3508
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    Fax                  |    757-686-0541
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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        |    174400000X
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    Taxonomy Name        |    Specialist
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    License Number       |    0101056807
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    License Number State |    VA
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