Provider Demographics
NPI:1578393112
Name:ZAMORA, ABIGAIL LEONOR (PA-C)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LEONOR
Last Name:ZAMORA
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:LEONOR
Other - Last Name:VARGAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1115 W CALL ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32304-3556
Mailing Address - Country:US
Mailing Address - Phone:850-328-5679
Mailing Address - Fax:
Practice Address - Street 1:2605 W SWANN AVE STE 600
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4044
Practice Address - Country:US
Practice Address - Phone:813-876-7073
Practice Address - Fax:813-877-1277
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9119746363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant