Provider Demographics
NPI:1730630880
Name:ZAMBRANA, RENE WALBERTO (DNP, ARNP)
Entity type:Individual
Prefix:DR
First Name:RENE
Middle Name:WALBERTO
Last Name:ZAMBRANA
Suffix:
Gender:M
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 SE SYCAMORE TER
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-6216
Mailing Address - Country:US
Mailing Address - Phone:386-758-0600
Mailing Address - Fax:386-758-0548
Practice Address - Street 1:751 SE SYCAMORE TER
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-6216
Practice Address - Country:US
Practice Address - Phone:386-758-0600
Practice Address - Fax:386-758-0548
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2529982363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care