Healthcare Provider Details

I. General information

NPI: 1376489609
Provider Name (Legal Business Name): ZARI GENESIS DEMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7341 OFFICE PARK PL STE 107
MELBOURNE FL
32940-8280
US

IV. Provider business mailing address

1168 ALTAIR WAY
MALABAR FL
32950-3377
US

V. Phone/Fax

Practice location:
  • Phone: 321-405-5500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-388728
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: