Provider Demographics
NPI:1629578265
Name:ZAMFIR, MARIANA (PTA)
Entity Type:Individual
Prefix:
First Name:MARIANA
Middle Name:
Last Name:ZAMFIR
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 VAN BUREN STREET
Mailing Address - Street 2:102
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-7301
Mailing Address - Country:US
Mailing Address - Phone:954-305-8947
Mailing Address - Fax:
Practice Address - Street 1:1418 S POWERLINE RD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-4300
Practice Address - Country:US
Practice Address - Phone:954-975-0771
Practice Address - Fax:954-975-0726
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27986225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant