Provider Demographics
NPI:1346063955
Name:ZAYAS NUNEZ, ANGEL LIAN
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:LIAN
Last Name:ZAYAS NUNEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4520 DAVIS CT
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-9534
Mailing Address - Country:US
Mailing Address - Phone:863-668-1061
Mailing Address - Fax:
Practice Address - Street 1:4520 DAVIS CT
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-9534
Practice Address - Country:US
Practice Address - Phone:863-668-1061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-02
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst