Provider Demographics
NPI:1396366886
Name:ZIMMER, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:ZIMMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 CRUMP RD
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-9243
Mailing Address - Country:US
Mailing Address - Phone:240-806-8040
Mailing Address - Fax:
Practice Address - Street 1:491 LAKE PARKER AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801
Practice Address - Country:US
Practice Address - Phone:862-824-6710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator