Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT13648 | FL |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 7685 | NC |
NPI | 1023240926 |
---|---|
Provider Name | Mr. Randy Zabala Agapito |
First Address | Raleigh, NC 27604-5442 |
Second Address | Raleigh, NC 27612-4189 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2009 |
Last Update Date | 12/02/2019 |