Provider Demographics
NPI:1033432513
Name:ZAYAS, HERSCLEVEN L
Entity Type:Individual
Prefix:MR
First Name:HERSCLEVEN
Middle Name:L
Last Name:ZAYAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18041 BISCAYNE BLVD APT 603
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-5249
Mailing Address - Country:US
Mailing Address - Phone:305-467-3800
Mailing Address - Fax:
Practice Address - Street 1:18041 BISCAYNE BLVD APT 603
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-5249
Practice Address - Country:US
Practice Address - Phone:305-467-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL08-243246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant