Provider Demographics
NPI:1679093488
Name:ZAMOR, NANCY (BS)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:ZAMOR
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 N STATE ROAD 7 STE 202
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4816
Mailing Address - Country:US
Mailing Address - Phone:954-801-1115
Mailing Address - Fax:
Practice Address - Street 1:20345 W COUNTRY CLUB DR # TH-17
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1631
Practice Address - Country:US
Practice Address - Phone:305-792-4931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-22
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 251E00000X, 253Z00000X
FL30212375251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL692436196Medicaid