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NPI Code Detail

MEDICARE: ZENTHEO LLC

MEDICARE: ZENTHEO LLC
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
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1437796661
Entity Type Code : Organization
Provider Name (Legal Business Name) : ZENTHEO LLC
Provider Business Mailing Address
First Line : 31 PEBBLE BEACH DR
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-3887
Country : US
Telephone Number : 386-986-0117
Fax Number :
Provider Business Practice Location Address
First Line : 495 S NOVA RD STE 101A
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-8444
Country : US
Telephone Number : 386-487-4673
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. STEPHANIE BURROWS
Credential : MD
Telephone Number : 386-986-0117
Provider Enumeration Date : 12/06/2019
Last Update Date : 12/06/2019

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Directions to “ZENTHEO LLC ” Practice Location

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