Provider Demographics
NPI:1326796384
Name:MONTES DE OCA, ZURIZADAY
Entity Type:Individual
Prefix:
First Name:ZURIZADAY
Middle Name:
Last Name:MONTES DE OCA
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 1:6496 W 11TH LN
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6442
Mailing Address - Country:US
Mailing Address - Phone:786-859-3125
Mailing Address - Fax:
Practice Address - Street 1:6496 W 11TH LN
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6442
Practice Address - Country:US
Practice Address - Phone:786-859-3125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-17
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-141914106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty