MEDICARE: MS. DIANNE ZAMUDIO

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	172V00000X	Community Health Worker
2	251E00000X	Home Health Agency

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194027193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DIANNE ZAMUDIO

Provider Business Mailing Address
First Line	:	PO BOX 5324
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32793-5324
Country	:	US
Telephone Number	:	407-860-5475
Fax Number	:	407-672-0866

Provider Business Practice Location Address
First Line	:	10821 FALLOW TRL
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32817-2081
Country	:	US
Telephone Number	:	407-860-5475
Fax Number	:	407-672-0866

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

Provider Enumeration Date	:	11/23/2010
Last Update Date	:	01/28/2014

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Directions to “ MS. DIANNE ZAMUDIO ” Practice Location

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