Provider Demographics
NPI:1356648844
Name:ZAKIAN, HEATHER L (PA-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:ZAKIAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:L
Other - Last Name:D'ANTONIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:224 CHIMNEY CORNER LANE
Mailing Address - Street 2:SUITE 3002
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:561-820-0155
Mailing Address - Fax:561-691-3281
Practice Address - Street 1:224 CHIMNEY CORNER LANE
Practice Address - Street 2:SUITE 3002
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-820-0155
Practice Address - Fax:561-691-3281
Is Sole Proprietor?:No
Enumeration Date:2011-02-17
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9105631363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant