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General NPI Number Information
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NPI Number | 1750105334
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Entity Type | Organization
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Legal Business Name | ZELENA NP LLC
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 3105 NW 107TH AVE STE 400-H11
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City | DORAL
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State | FL
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Zip | 33172-2185
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Country | US
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Telephone | 305-514-9045
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Fax |
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Provider Business Mailing Address
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Address Line | 9765 NW 45TH LN
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City | DORAL
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State | FL
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Zip | 33178-3367
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Country | US
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Telephone | 754-244-4322
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ZOILA ANTA VERGARA
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Credential | ARNP-PMHNP-BC
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Telephone | 754-244-4322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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