Basic Information
| Provider Information | |||||||||
| NPI: | 1295068526 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ZUNZUN THERAPEUTIC CARE, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | FIRST CHOICE THERAPY GROUP, LLC | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13909 N DALE MABRY HWY | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336182436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134435726 | ||||||||
| FaxNumber: | 8134435727 | ||||||||
| Practice Location | |||||||||
| Address1: | 13909 N DALE MABRY HWY | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336182436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134435726 | ||||||||
| FaxNumber: | 8134435727 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2009 | ||||||||
| LastUpdateDate: | 10/29/2012 | ||||||||
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| AuthorizedOfficialLastName: | MOREIRA | ||||||||
| AuthorizedOfficialFirstName: | MAYUMI | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8134435726 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | LMT | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | MM29385 | FL | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.