Provider Demographics
NPI:1215409511
Name:ZOZAYA, BEATRIZ
Entity type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:
Last Name:ZOZAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11981 SW 144TH CT STE 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-8653
Mailing Address - Country:US
Mailing Address - Phone:786-459-0109
Mailing Address - Fax:
Practice Address - Street 1:11981 SW 144TH CT STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-8653
Practice Address - Country:US
Practice Address - Phone:786-459-0109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-26
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCM101277171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator