Provider Demographics
NPI:1558776153
Name:ZATYKO, DONNA (LMT)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:
Last Name:ZATYKO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:BUNNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5911 HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-8603
Mailing Address - Country:US
Mailing Address - Phone:772-882-7329
Mailing Address - Fax:
Practice Address - Street 1:5911 HICKORY DR
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-8603
Practice Address - Country:US
Practice Address - Phone:772-882-7329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA23260173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC8952OtherFLORIDA BLUE