Provider Demographics
NPI:1699522821
Name:ZAYAS TORRES, KEVIN (CAA)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:ZAYAS TORRES
Suffix:
Gender:M
Credentials:CAA
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:
Other - Last Name:ZAYAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:422 RIVER POINT DR LOT 31
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-4041
Mailing Address - Country:US
Mailing Address - Phone:813-494-3992
Mailing Address - Fax:
Practice Address - Street 1:2776 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-5864
Practice Address - Country:US
Practice Address - Phone:239-343-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAA983367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant