Provider Demographics
NPI:1285968727
Name:ZACCARO, LYDIA A (RN, LAP)
Entity type:Individual
Prefix:MS
First Name:LYDIA
Middle Name:A
Last Name:ZACCARO
Suffix:
Gender:F
Credentials:RN, LAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 PRESIDENTIAL WAY
Mailing Address - Street 2:203
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401
Mailing Address - Country:US
Mailing Address - Phone:561-251-0084
Mailing Address - Fax:
Practice Address - Street 1:801 MEADOWS RD
Practice Address - Street 2:114
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486
Practice Address - Country:US
Practice Address - Phone:561-750-3520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2583072163W00000X
FLAP 1320171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163W00000XNursing Service ProvidersRegistered Nurse