Provider Demographics
NPI:1801399159
Name:PINDAR, ZACHARY BROOK BOUDER (OTR/L)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:BROOK BOUDER
Last Name:PINDAR
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:ZACHARY
Other - Middle Name:B
Other - Last Name:PINDAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:4865 CYPRESS WOODS DR APT 2107
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-3763
Mailing Address - Country:US
Mailing Address - Phone:845-826-0705
Mailing Address - Fax:
Practice Address - Street 1:1297 WINTER GARDEN VINELAND RD # 112
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-6706
Practice Address - Country:US
Practice Address - Phone:407-852-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19080225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist