MEDICARE: FRANTISEV ZAMBRANA COLLS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	9268724	FL
2	363LP2300X	Primary Care Nurse Practitioner	APRN11025307	FL
3	363LF0000X	Family Nurse Practitioner	APRN11025307	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093114928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANTISEV ZAMBRANA COLLS

Provider Business Mailing Address
First Line	:	6423 SW 162ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33193-5833
Country	:	US
Telephone Number	:	786-246-8739
Fax Number	:	786-513-6146

Provider Business Practice Location Address
First Line	:	14732 SW 56TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-4041
Country	:	US
Telephone Number	:	786-668-6396
Fax Number	:	786-513-6136

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2014
Last Update Date	:	08/07/2023

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