Provider Demographics
NPI:1477163178
Name:ZARAYASI, DIANA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:ZARAYASI
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 1:2841 NE 163RD ST APT 1106
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4443
Mailing Address - Country:US
Mailing Address - Phone:305-508-2618
Mailing Address - Fax:
Practice Address - Street 1:2841 NE 163RD ST APT 1106
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4443
Practice Address - Country:US
Practice Address - Phone:305-508-2618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW139531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty