Healthcare Provider Details

I. General information

NPI: 1760139877
Provider Name (Legal Business Name): ZYLAHS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2022
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7437 39TH PL N
SAINT PETERSBURG FL
33709-4310
US

IV. Provider business mailing address

7437 39TH PL N
SAINT PETERSBURG FL
33709-4310
US

V. Phone/Fax

Practice location:
  • Phone: 727-504-3289
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: KIERRA COSTON
Title or Position: OWNER
Credential:
Phone: 727-504-3289