Provider Demographics
NPI:1255471777
Name:ZIMBRUNES, JOSE HENRY (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:HENRY
Last Name:ZIMBRUNES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1212 KATHRYN RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2175
Mailing Address - Country:US
Mailing Address - Phone:301-680-9560
Mailing Address - Fax:301-891-6313
Practice Address - Street 1:1212 KATHRYN RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2175
Practice Address - Country:US
Practice Address - Phone:301-680-9560
Practice Address - Fax:301-891-6313
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0000463363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical