Provider Demographics
NPI:1336732783
Name:COEN, ZACHARIAH (RD, LN)
Entity Type:Individual
Prefix:
First Name:ZACHARIAH
Middle Name:
Last Name:COEN
Suffix:
Gender:M
Credentials:RD, LN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 89266
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33689-0404
Mailing Address - Country:US
Mailing Address - Phone:813-727-1616
Mailing Address - Fax:
Practice Address - Street 1:30306 RATTANA CT
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-1368
Practice Address - Country:US
Practice Address - Phone:813-727-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Single Specialty