Provider Demographics
NPI:1487197430
Name:ZEA, VIRGINIA
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:ZEA
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 1:16177 POPPYSEED CIR UNIT 505
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6321
Mailing Address - Country:US
Mailing Address - Phone:561-557-1990
Mailing Address - Fax:561-469-6697
Practice Address - Street 1:16177 POPPYSEED CIR UNIT 505
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6321
Practice Address - Country:US
Practice Address - Phone:561-557-1990
Practice Address - Fax:561-469-6697
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-23
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist