Provider Demographics
NPI:1750548343
Name:ZULLO, CHRISTINE I (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:I
Last Name:ZULLO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4855 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE B13
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4356
Mailing Address - Country:US
Mailing Address - Phone:954-420-9182
Mailing Address - Fax:954-420-9184
Practice Address - Street 1:4855 W HILLSBORO BLVD
Practice Address - Street 2:SUITE B13
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4356
Practice Address - Country:US
Practice Address - Phone:954-420-9182
Practice Address - Fax:954-420-9184
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104501363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant