Provider Demographics
NPI:1265770002
Name:ZAMORA, CAROL NANCY (FNP-BC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:NANCY
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 CORPORATE WAY STE D
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5603
Mailing Address - Fax:954-985-7073
Practice Address - Street 1:4651 SHERIDAN ST STE 350
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3425
Practice Address - Country:US
Practice Address - Phone:954-276-8559
Practice Address - Fax:954-966-9762
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9182474363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily