Healthcare Provider Details

I. General information

NPI: 1053936872
Provider Name (Legal Business Name): KAREN IDALIA ZITOUNI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2020
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LILBURN SCHOOL RD NW APT F4
LILBURN GA
30047-4934
US

IV. Provider business mailing address

500 LILBURN SCHOOL RD NW APT F4
LILBURN GA
30047-4934
US

V. Phone/Fax

Practice location:
  • Phone: 786-834-2596
  • Fax:
Mailing address:
  • Phone: 786-834-2596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: