Provider Demographics
NPI:1427579069
Name:MOOREHEAD-MCKIE, ZYA'NEL
Entity Type:Individual
Prefix:
First Name:ZYA'NEL
Middle Name:
Last Name:MOOREHEAD-MCKIE
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 1:2030 SKIDDAW CT
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-6432
Mailing Address - Country:US
Mailing Address - Phone:340-642-6322
Mailing Address - Fax:
Practice Address - Street 1:4000 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32816-0001
Practice Address - Country:US
Practice Address - Phone:407-823-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty