Provider Demographics
NPI:1326549312
Name:ZAYAS, NIKI MIGUELITA (RBT)
Entity Type:Individual
Prefix:
First Name:NIKI
Middle Name:MIGUELITA
Last Name:ZAYAS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 GANDY BLVD N APT 521
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2306
Mailing Address - Country:US
Mailing Address - Phone:404-604-7159
Mailing Address - Fax:
Practice Address - Street 1:3904 17TH ST E
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-9501
Practice Address - Country:US
Practice Address - Phone:941-723-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-24
Last Update Date:2018-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty