Provider Demographics
NPI:1215476676
Name:FANCE, ZAHMILIA
Entity type:Individual
Prefix:MS
First Name:ZAHMILIA
Middle Name:
Last Name:FANCE
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 1:3320 NW 176TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-3945
Mailing Address - Country:US
Mailing Address - Phone:954-909-9366
Mailing Address - Fax:305-623-7992
Practice Address - Street 1:3320 NW 176TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-3945
Practice Address - Country:US
Practice Address - Phone:954-909-9366
Practice Address - Fax:305-623-7992
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-18
Last Update Date:2017-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL172V00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No172V00000XOther Service ProvidersCommunity Health Worker