Provider Demographics
NPI:1215644216
Name:CARDOSO, ZAILYN
Entity type:Individual
Prefix:
First Name:ZAILYN
Middle Name:
Last Name:CARDOSO
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 1:530 SW 42ND AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1966
Mailing Address - Country:US
Mailing Address - Phone:786-420-1470
Mailing Address - Fax:
Practice Address - Street 1:240 W PALMETTO PARK RD STE 300C
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-3761
Practice Address - Country:US
Practice Address - Phone:561-430-3611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-239273106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician