Provider Demographics
NPI:1962618348
Name:ZAYAS-BAZAN, MARIA M (PSYD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:M
Last Name:ZAYAS-BAZAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MAJORCA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4508
Mailing Address - Country:US
Mailing Address - Phone:305-815-5903
Mailing Address - Fax:
Practice Address - Street 1:101 MAJORCA AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4508
Practice Address - Country:US
Practice Address - Phone:305-815-5903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7521103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH5974OtherLICENSE