Healthcare Provider Details

I. General information

NPI: 1548125297
Provider Name (Legal Business Name): ZAKIYA MIKELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2953 MORRIS DR
BARTOW FL
33830-8714
US

IV. Provider business mailing address

PO BOX 177
BARTOW FL
33831-0177
US

V. Phone/Fax

Practice location:
  • Phone: 689-808-4300
  • Fax:
Mailing address:
  • Phone: 863-219-6597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: