Healthcare Provider Details

I. General information

NPI: 1154952638
Provider Name (Legal Business Name): ANDREA ZAPATA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2020
Last Update Date: 09/12/2020
Certification Date: 09/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15836 SW 137TH AVE
MIAMI FL
33177-1203
US

IV. Provider business mailing address

15836 SW 137TH AVE
MIAMI FL
33177-1203
US

V. Phone/Fax

Practice location:
  • Phone: 786-356-7499
  • Fax:
Mailing address:
  • Phone: 786-356-7499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: