Provider Demographics
NPI:1407945520
Name:ZAPATA, EMILIO SIFREDO II (DMD)
Entity Type:Individual
Prefix:DR
First Name:EMILIO
Middle Name:SIFREDO
Last Name:ZAPATA
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6646 OLD WINTER GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-1231
Mailing Address - Country:US
Mailing Address - Phone:407-292-6400
Mailing Address - Fax:
Practice Address - Street 1:6646 OLD WINTER GARDEN RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-1231
Practice Address - Country:US
Practice Address - Phone:407-292-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00113991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN0011399OtherDENTAL LISCENCE
FL072692300Medicaid
FL63537Medicare ID - Type Unspecified