Provider Demographics
NPI:1386250892
Name:ZUBIZARRETA, TERESA
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:ZUBIZARRETA
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 1:13253 SW 110TH TER APT 2
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4394
Mailing Address - Country:US
Mailing Address - Phone:305-519-6907
Mailing Address - Fax:
Practice Address - Street 1:13253 SW 110TH TER APT 2
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4394
Practice Address - Country:US
Practice Address - Phone:305-519-6907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-20
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11437101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health