Individual
PAUL DAVID ZETTEROWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
3625 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4207
(904) 399-6190
Mailing address
7244 SAN JOSE BLVD, JACKSONVILLE, FL 32217-3426
(904) 327-1423
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP9234772
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
768585800
—
FL
01
—
P00430939
RR MEDICARE
FL
01
—
Y113B
BCBS
FL
Enumeration date
05/07/2007
Last updated
12/17/2012
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