Provider Demographics
NPI:1629540133
Name:ZAPALA, CAROL (RN)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:ZAPALA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FLORIDA BLUE CENTER IN THE MARKET AT TOWN CENTER
Mailing Address - Street 2:4855 TOWN CENTER PARKWAY
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-8437
Mailing Address - Country:US
Mailing Address - Phone:904-363-5870
Mailing Address - Fax:
Practice Address - Street 1:FLORIDA BLUE CENTER IN THE MARKET AT TOWN CENTER
Practice Address - Street 2:4855 TOWN CENTER PARKWAY
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-8437
Practice Address - Country:US
Practice Address - Phone:904-363-5870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9202666163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse