Provider Demographics
NPI:1437796661
Name:ZENTHEO LLC
Entity Type:Organization
Organization Name:ZENTHEO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURROWS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-986-0117
Mailing Address - Street 1:31 PEBBLE BEACH DR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-3887
Mailing Address - Country:US
Mailing Address - Phone:386-986-0117
Mailing Address - Fax:
Practice Address - Street 1:495 S NOVA RD STE 101A
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8444
Practice Address - Country:US
Practice Address - Phone:386-487-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty