Provider Demographics
NPI:1649229980
Name:ZAMBRANO, PERLA
Entity Type:Individual
Prefix:
First Name:PERLA
Middle Name:
Last Name:ZAMBRANO
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 1:6282 LINTON BLVD
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6416
Mailing Address - Country:US
Mailing Address - Phone:561-495-8307
Mailing Address - Fax:561-495-6422
Practice Address - Street 1:6282 LINTON BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6416
Practice Address - Country:US
Practice Address - Phone:561-495-8307
Practice Address - Fax:561-495-6422
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2065642363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
U3151ZMedicare ID - Type Unspecified
Q22323Medicare UPIN