Provider Demographics
NPI:1386236537
Name:ZAYAS LOPEZ, NECTOR (CBHCMS101043)
Entity type:Individual
Prefix:
First Name:NECTOR
Middle Name:
Last Name:ZAYAS LOPEZ
Suffix:
Gender:M
Credentials:CBHCMS101043
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9029 NW 145TH LANE
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018
Mailing Address - Country:US
Mailing Address - Phone:929-330-5893
Mailing Address - Fax:
Practice Address - Street 1:5190 NW 167TH ST STE 309
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-3301
Practice Address - Country:US
Practice Address - Phone:305-705-4289
Practice Address - Fax:786-657-2372
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty