Provider Demographics
NPI:1275227399
Name:ZERBONIA, ZACHARY SLADE (DPT)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:SLADE
Last Name:ZERBONIA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6139 55TH AVENUE CIR E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-9755
Mailing Address - Country:US
Mailing Address - Phone:305-934-9969
Mailing Address - Fax:
Practice Address - Street 1:420 W BELMONT AVE APT 25B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4734
Practice Address - Country:US
Practice Address - Phone:305-934-9969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19974225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist