Provider Demographics
NPI:1407324197
Name:ZORNBERG, ALMA (COTA)
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:
Last Name:ZORNBERG
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:ALMA
Other - Middle Name:
Other - Last Name:ZORNBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA
Mailing Address - Street 1:1502 15TH LN
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-4359
Mailing Address - Country:US
Mailing Address - Phone:561-629-4993
Mailing Address - Fax:
Practice Address - Street 1:336 S POWERLINE RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BCH
Practice Address - State:FL
Practice Address - Zip Code:33442-8105
Practice Address - Country:US
Practice Address - Phone:561-629-4993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-11
Last Update Date:2018-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA15968405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional