Provider Demographics
NPI:1841334133
Name:ZAMBRANO, MARTHA (BS)
Entity type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:
Last Name:ZAMBRANO
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8952 IRON OAK AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2999
Mailing Address - Country:US
Mailing Address - Phone:813-994-7254
Mailing Address - Fax:813-973-4797
Practice Address - Street 1:8952 IRON OAK AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2999
Practice Address - Country:US
Practice Address - Phone:813-994-7254
Practice Address - Fax:813-973-4797
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI 9622355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8202150 00Medicaid