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General NPI Number Information
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NPI Number | 1346761244
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Entity Type | Individual
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Provider Name | THAYRA MARIE ZAMBRANA-NIEVES PSYD
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Gender | Female
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 381 N KROME AVE STE 111
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City | HOMESTEAD
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State | FL
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Zip | 33030-6047
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Country | US
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Telephone | 305-824-6801
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Fax |
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Provider Business Mailing Address
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Address Line | 3020 NE 41ST TERRACE SUITE 9 #207
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City | HOMESTEAD
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State | FL
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Zip | 33033-1920
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Country | US
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Telephone | 305-824-6801
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY9732
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PY9732
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License Number State | FL
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