Provider Demographics
NPI:1720693930
Name:ZAPATA, ETHEL ISABEL
Entity Type:Individual
Prefix:MRS
First Name:ETHEL
Middle Name:ISABEL
Last Name:ZAPATA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8292 CALABRIA LAKES DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-4944
Mailing Address - Country:US
Mailing Address - Phone:786-547-9224
Mailing Address - Fax:
Practice Address - Street 1:8292 CALABRIA LAKES DR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33473-4944
Practice Address - Country:US
Practice Address - Phone:786-547-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA94703225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist