Healthcare Provider Details

I. General information

NPI: 1659024073
Provider Name (Legal Business Name): LIAT ZAKAY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2022
Last Update Date: 01/27/2022
Certification Date: 01/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4725 N FEDERAL HWY
FT LAUDERDALE FL
33308-4603
US

IV. Provider business mailing address

600 KINGSMILL CV APT 110
LAKE MARY FL
32746-5839
US

V. Phone/Fax

Practice location:
  • Phone: 954-771-8000
  • Fax:
Mailing address:
  • Phone: 407-302-0089
  • Fax: 407-807-7500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: LIAT ZAKAY
Title or Position: OWNER
Credential: CSFA
Phone: 786-277-2797