Provider Demographics
NPI:1801565783
Name:WALTERS, ZACHARY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:WALTERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12211 W HILLSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-9778
Mailing Address - Country:US
Mailing Address - Phone:724-312-4218
Mailing Address - Fax:
Practice Address - Street 1:12211 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-9778
Practice Address - Country:US
Practice Address - Phone:813-925-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS63198183500000X
PARP456686183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist