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NPI Code Detail

MEDICARE: JENNIFER ZIMMER

MEDICARE: JENNIFER ZIMMER
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
1106S00000XBehavior Technician

Other Identifiers

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

General Provider Information

NPI Number : 1760716468
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER ZIMMER
Provider Business Mailing Address
First Line : 2035 SW 75TH ST STE B
Second Line :
City : GAINESVILLE
State : FL
Zip : 32607-3425
Country : US
Telephone Number : 352-332-8588
Fax Number :
Provider Business Practice Location Address
First Line : 4817 EHRLICH RD
Second Line :
City : TAMPA
State : FL
Zip : 33624-2037
Country : US
Telephone Number : 352-332-8588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2009
Last Update Date : 12/04/2018

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Directions to “ JENNIFER ZIMMER ” Practice Location

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