Provider Demographics
NPI:1811464944
Name:ZAPANTA, MICHAEL ANGELO RACHO (PT)
Entity type:Individual
Prefix:
First Name:MICHAEL ANGELO
Middle Name:RACHO
Last Name:ZAPANTA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 GREEN PINE BLVD APT G
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-7033
Mailing Address - Country:US
Mailing Address - Phone:561-687-3736
Mailing Address - Fax:
Practice Address - Street 1:931 VILLAGE BLVD STE 903
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-1939
Practice Address - Country:US
Practice Address - Phone:561-313-3304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19867225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty