MEDICARE: ZENAIDA PAULA PSY.D.

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	103TC0700X	Clinical Psychologist	8114	FL

General Provider Information

NPI Number	:	1376855684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZENAIDA PAULA PSY.D.

Provider Business Mailing Address
First Line	:	3460 N KEY DR APT 503
Second Line	:
City	:	N FORT MYERS
State	:	FL
Zip	:	33903-7033
Country	:	US
Telephone Number	:	239-303-2583
Fax Number	:

Provider Business Practice Location Address
First Line	:	3460 N KEY DR APT 503
Second Line	:
City	:	N FORT MYERS
State	:	FL
Zip	:	33903-7033
Country	:	US
Telephone Number	:	239-303-2583
Fax Number	:

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

Provider Enumeration Date	:	07/02/2010
Last Update Date	:	09/09/2021

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