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NPI Code Detail

MEDICARE: CASSANDRA MIRIAM ZACKE APRN

MEDICARE:   CASSANDRA MIRIAM ZACKE  APRN
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
1363LF0000XFamily Nurse PractitionerAPRN11005090FL

General Provider Information

NPI Number : 1689296030
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA MIRIAM ZACKE APRN
Provider Business Mailing Address
First Line : 8220 SW 96TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33156-2449
Country : US
Telephone Number : 305-772-1529
Fax Number :
Provider Business Practice Location Address
First Line : 8220 SW 96TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33156-2449
Country : US
Telephone Number : 305-772-1529
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2020
Last Update Date : 05/08/2020

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Directions to “ CASSANDRA MIRIAM ZACKE APRN” Practice Location

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