Healthcare Provider Details

I. General information

NPI: 1306077201
Provider Name (Legal Business Name): IRENE OTANO ZAS RN, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2009
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

2255 SW 134TH CT
MIAMI FL
33175-1132
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-3621
  • Fax: 786-596-2841
Mailing address:
  • Phone: 786-301-4855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0037912
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11000622
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9250119
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: