Provider Demographics
NPI:1326221086
Name:GLORIA I. ZAPATA PEDIATRIC THERAPY CENTER, INC.
Entity Type:Organization
Organization Name:GLORIA I. ZAPATA PEDIATRIC THERAPY CENTER, INC.
Other - Org Name:KIDS FIRST THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:I
Authorized Official - Last Name:ZAPATA
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:352-683-2120
Mailing Address - Street 1:246 MARINER BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609
Mailing Address - Country:US
Mailing Address - Phone:352-683-9232
Mailing Address - Fax:352-683-9232
Practice Address - Street 1:246 MARINER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5691
Practice Address - Country:US
Practice Address - Phone:352-683-9232
Practice Address - Fax:352-683-9232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT12434174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL891725600Medicaid