Healthcare Provider Details

I. General information

NPI: 1306781091
Provider Name (Legal Business Name): MAIA ZOCK-OBREGON
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

478 E ALTAMONTE DR STE 108251
ALTAMONTE SPRINGS FL
32701-4628
US

IV. Provider business mailing address

15408 SW 50TH TER
MIAMI FL
33185-4440
US

V. Phone/Fax

Practice location:
  • Phone: 786-432-5464
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH26664
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: