Healthcare Provider Details

I. General information

NPI: 1689105249
Provider Name (Legal Business Name): SUMIKO RUIZ ZAYON BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15725 SW 89TH AVE
PALMETTO BAY FL
33157-1908
US

IV. Provider business mailing address

15725 SW 89TH AVE
PALMETTO BAY FL
33157-1908
US

V. Phone/Fax

Practice location:
  • Phone: 786-907-0396
  • Fax:
Mailing address:
  • Phone: 786-907-0396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBACB1-26-89873
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: