Healthcare Provider Details

I. General information

NPI: 1255508172
Provider Name (Legal Business Name): ZOILA S. DANTA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 08/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11031 NE 6TH AVE
MIAMI FL
33161-7182
US

IV. Provider business mailing address

11031 NE 6TH AVE
MIAMI FL
33161-7182
US

V. Phone/Fax

Practice location:
  • Phone: 305-398-6123
  • Fax: 305-757-2387
Mailing address:
  • Phone: 305-398-6100
  • Fax: 305-757-2387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 2920
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: