Basic Information
Provider Information
NPI: 1548526270
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZAPATA
FirstName: MARIA CRISTINA
MiddleName: RANESES
NamePrefix: MRS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: RANESES
OtherFirstName: MARIA CRISTINA
OtherMiddleName: MAGCALAS
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1580 SAWGRASS CORPORATE PKWY
Address2: SUITE 100
City: SUNRISE
State: FL
PostalCode: 333232859
CountryCode: US
TelephoneNumber: 8008868108
FaxNumber:  
Practice Location
Address1: 1580 SAWGRASS CORPORATE PKWY
Address2: SUITE 100
City: SUNRISE
State: FL
PostalCode: 333232859
CountryCode: US
TelephoneNumber: 8008868108
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/06/2012
LastUpdateDate: 04/06/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XJ1-0002598DEY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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