Provider Demographics
NPI:1477185783
Name:ZAPATA, LIZ SAMARA
Entity Type:Individual
Prefix:MRS
First Name:LIZ
Middle Name:SAMARA
Last Name:ZAPATA
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 1:18644 SINGLETARY LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33194-2708
Mailing Address - Country:US
Mailing Address - Phone:786-848-5342
Mailing Address - Fax:
Practice Address - Street 1:18644 SINGLETARY LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33194-2708
Practice Address - Country:US
Practice Address - Phone:786-848-5342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-92161106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician