Provider Demographics
NPI:1497397079
Name:HERNANDEZ ZAYAS, BARBARA YANET
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:YANET
Last Name:HERNANDEZ ZAYAS
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 1:10689 N KENDALL DR STE 309
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1525
Mailing Address - Country:US
Mailing Address - Phone:786-536-7470
Mailing Address - Fax:786-536-7951
Practice Address - Street 1:8005 NW 8TH ST APT 317
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2853
Practice Address - Country:US
Practice Address - Phone:786-803-7420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-102160106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty