Provider Demographics
NPI:1720894199
Name:ZODU THERAPY LLC
Entity type:Organization
Organization Name:ZODU THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:DUANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-986-6595
Mailing Address - Street 1:1250 W SR 434 STE 1000
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4969
Mailing Address - Country:US
Mailing Address - Phone:689-304-9638
Mailing Address - Fax:
Practice Address - Street 1:1250 W SR 434 STE 1000
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4969
Practice Address - Country:US
Practice Address - Phone:689-304-9638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center