Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT008090 | FL |
NPI | 1144643958 |
---|---|
Provider Name | Diana Zarreke |
First Address | Tampa, FL 33606-2210 |
Second Address | Tampa, FL 33606-2210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2014 |
Last Update Date | 29/01/2014 |