Provider Demographics
NPI:1013981125
Name:ZAK, ALLEN THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:THOMAS
Last Name:ZAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 RICKENBACKER DR
Mailing Address - Street 2:SUITE #2
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-5332
Mailing Address - Country:US
Mailing Address - Phone:813-634-8980
Mailing Address - Fax:813-634-2593
Practice Address - Street 1:1601 RICKENBACKER DR
Practice Address - Street 2:SUITE #2
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5332
Practice Address - Country:US
Practice Address - Phone:813-634-8980
Practice Address - Fax:813-634-2593
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5698111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL050266900Medicaid
FL350013655OtherRAILROAD MEDICARE
FL22072Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
FLT54819Medicare UPIN