Provider Demographics
NPI:1356093769
Name:ZAPATA, JADY
Entity Type:Individual
Prefix:
First Name:JADY
Middle Name:
Last Name:ZAPATA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3359 GARDENS EAST DR APT B
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4950
Mailing Address - Country:US
Mailing Address - Phone:561-878-7546
Mailing Address - Fax:
Practice Address - Street 1:9910 ALTERNATE A1A STE 707
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4937
Practice Address - Country:US
Practice Address - Phone:201-961-2719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSL3400355225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist