Provider Demographics
NPI:1093415176
Name:HAEDO GARCIA, ZORAIDA (PTA)
Entity Type:Individual
Prefix:
First Name:ZORAIDA
Middle Name:
Last Name:HAEDO GARCIA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9320 FONTAINEBLEAU BLVD APT 415
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4236
Mailing Address - Country:US
Mailing Address - Phone:786-260-5517
Mailing Address - Fax:
Practice Address - Street 1:5985 W 25TH CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-4462
Practice Address - Country:US
Practice Address - Phone:305-557-2328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27304225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant