MEDICARE: WEST PALM UVC MEDICAL PLLC

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	202K00000X	Phlebology Physician

General Provider Information

NPI Number	:	1114894813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST PALM UVC MEDICAL PLLC

Provider Business Mailing Address
First Line	:	3820 NORTHDALE BLVD STE 201
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-1893
Country	:	US
Telephone Number	:	813-961-1331
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 GLADES RD STE 100
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33431-7333
Country	:	US
Telephone Number	:	800-991-6117
Fax Number	:

Authorized Official
Title or Position	:	CMO
Name	:	DR. DOMENIC ZAMBUTO
Credential	:	MD
Telephone Number	:	813-683-4784

Provider Enumeration Date	:	10/20/2025
Last Update Date	:	10/22/2025

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