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General NPI Number Information
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NPI Number | 1285947358
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Entity Type | Individual
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Provider Name | MARINA LISA ZAKALA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 11673 W HEDGEHOG CT
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City | SURPRISE
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State | AZ
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Zip | 85374-2538
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Country | US
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Telephone | 623-215-4264
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Fax | 914-339-8193
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Provider Business Mailing Address
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Address Line | 11673 W HEDGEHOG CT
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City | SURPRISE
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State | AZ
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Zip | 85374-2538
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Country | US
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Telephone | 623-215-4264
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Fax | 914-339-8193
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 18863
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License Number State | AZ
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