Provider Demographics
NPI:1003472325
Name:BARRETO, ZULEISHKA
Entity Type:Individual
Prefix:
First Name:ZULEISHKA
Middle Name:
Last Name:BARRETO
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 1:1765 GRAND PT BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-5801
Mailing Address - Country:US
Mailing Address - Phone:787-452-4564
Mailing Address - Fax:
Practice Address - Street 1:1765 GRAND PT BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-5801
Practice Address - Country:US
Practice Address - Phone:787-452-4564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLB632980919010OtherDRIVERS LICENSE