Provider Demographics
NPI:1497155741
Name:SEGEV, ZUZANA (PHD, ARNP,PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ZUZANA
Middle Name:
Last Name:SEGEV
Suffix:
Gender:F
Credentials:PHD, ARNP,PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2662 LPGA BLVD # 707
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32124-1008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:139 EXECUTIVE CIR STE 104
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-7102
Practice Address - Country:US
Practice Address - Phone:386-400-3077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-22
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9382424363LP0808X
FLAPRN9382424363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013223800Medicaid
HY204ZMedicare PIN