Provider Demographics
NPI:1649785015
Name:ZBIKOWSKI, MATTHEW (MA, ATC, LAT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:ZBIKOWSKI
Suffix:
Gender:M
Credentials:MA, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 BULLDOG LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-5268
Mailing Address - Country:US
Mailing Address - Phone:407-891-3100
Mailing Address - Fax:407-891-3114
Practice Address - Street 1:2000 BULLDOG LN
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-5268
Practice Address - Country:US
Practice Address - Phone:407-891-3100
Practice Address - Fax:407-891-3100
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL16222255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer