Provider Demographics
NPI:1710567037
Name:CALLAHAN, ZOE (BSN, MSN, CPNP-PC)
Entity Type:Individual
Prefix:MS
First Name:ZOE
Middle Name:
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:BSN, MSN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 MALCOM RD
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-1941
Mailing Address - Country:US
Mailing Address - Phone:407-920-4242
Mailing Address - Fax:
Practice Address - Street 1:1203 RUSSELL DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-1957
Practice Address - Country:US
Practice Address - Phone:407-756-7658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9383993163W00000X
FL11012616363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN11012616OtherFL BON