Provider Demographics
NPI:1346923810
Name:ZAFRA, MAGALY (CCPA LISENCE AND CRC)
Entity Type:Individual
Prefix:MS
First Name:MAGALY
Middle Name:
Last Name:ZAFRA
Suffix:
Gender:F
Credentials:CCPA LISENCE AND CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 140161
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-0161
Mailing Address - Country:US
Mailing Address - Phone:786-357-2140
Mailing Address - Fax:
Practice Address - Street 1:6447 MIAMI LAKES DR STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2765
Practice Address - Country:US
Practice Address - Phone:786-357-2140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1744R1102X
FLCI987363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No1744R1102XOther Service ProvidersSpecialistResearch Study