Provider Demographics
NPI:1558728725
Name:ZABALA, AMPARO
Entity Type:Individual
Prefix:
First Name:AMPARO
Middle Name:
Last Name:ZABALA
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 1:2209 NE 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-3425
Mailing Address - Country:US
Mailing Address - Phone:239-223-1827
Mailing Address - Fax:
Practice Address - Street 1:2209 NE 9TH AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-3425
Practice Address - Country:US
Practice Address - Phone:239-223-1827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program