Provider Demographics
NPI:1306961875
Name:ZALKIND, IMAZULAY (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:IMAZULAY
Middle Name:
Last Name:ZALKIND
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 S OCEAN DR APT 605
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7676
Mailing Address - Country:US
Mailing Address - Phone:954-496-2644
Mailing Address - Fax:
Practice Address - Street 1:1850 S OCEAN DR APT 605
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-7676
Practice Address - Country:US
Practice Address - Phone:954-496-2644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8924235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL891293900Medicaid