Provider Demographics
NPI:1982425153
Name:MAUGHERMAN, ZACHARY TALON
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:TALON
Last Name:MAUGHERMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 ROTONDA CIR
Mailing Address - Street 2:
Mailing Address - City:ROTONDA WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33947-2127
Mailing Address - Country:US
Mailing Address - Phone:941-830-3749
Mailing Address - Fax:
Practice Address - Street 1:1116 ROTONDA CIR
Practice Address - Street 2:
Practice Address - City:ROTONDA WEST
Practice Address - State:FL
Practice Address - Zip Code:33947-2127
Practice Address - Country:US
Practice Address - Phone:941-830-3749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
224Z00000X
FLOT25956225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant