Healthcare Provider Details

I. General information

NPI: 1063113629
Provider Name (Legal Business Name): RAZ MINDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2023
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 W KENNEDY BLVD STE 100
TAMPA FL
33609-2457
US

IV. Provider business mailing address

5401 W KENNEDY BLVD STE 100
TAMPA FL
33609-2457
US

V. Phone/Fax

Practice location:
  • Phone: 813-922-2274
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. REENA ANISH ZACHARIAH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 813-922-2274