Provider Demographics
NPI:1336312990
Name:ZAYAS, DIANA IVONE (MSW)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:IVONE
Last Name:ZAYAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 OAK LEAF LN
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-2840
Mailing Address - Country:US
Mailing Address - Phone:863-514-7456
Mailing Address - Fax:
Practice Address - Street 1:1446 OAK LEAF LN
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-2840
Practice Address - Country:US
Practice Address - Phone:863-514-7456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5084104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker