Healthcare Provider Details

I. General information

NPI: 1699438903
Provider Name (Legal Business Name): ZAFARULLA A MITHAVAYANI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2021
Last Update Date: 10/14/2021
Certification Date: 10/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 N UNIVERSITY DR STE 209
CORAL SPRINGS FL
33071-6078
US

IV. Provider business mailing address

1075 RIVERSIDE DR APT 407
CORAL SPRINGS FL
33071-7022
US

V. Phone/Fax

Practice location:
  • Phone: 786-909-4567
  • Fax:
Mailing address:
  • Phone: 786-909-4567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: