MEDICARE: DIANA ZAK MS. SP. ED.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)
2	106S00000X	Behavior Technician	RBT-23-277531	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326458654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA ZAK MS. SP. ED.

Provider Business Mailing Address
First Line	:	299 PRESTON H
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33434-4905
Country	:	US
Telephone Number	:	917-770-8226
Fax Number	:	305-402-8554

Provider Business Practice Location Address
First Line	:	299 PRESTON H
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33434-4905
Country	:	US
Telephone Number	:	917-770-8226
Fax Number	:	305-402-8554

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2014
Last Update Date	:	06/08/2023

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