Individual
IMELDA ZEPEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3501 WEST VINE ST #273, KISSIMMEE, FL 24741
(810) 627-4920
Mailing address
3500 POSNER BLVD # 1030, DAVENPORT, FL 33837-3640
(810) 627-4920
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCM104171
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N.A
N/A
—
Enumeration date
12/08/2022
Last updated
12/08/2022
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