Provider Demographics
NPI:1609424159
Name:MAGANA, ZARA ELIZABETH
Entity Type:Individual
Prefix:
First Name:ZARA
Middle Name:ELIZABETH
Last Name:MAGANA
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 1:365 S MARION AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-5233
Mailing Address - Country:US
Mailing Address - Phone:386-965-1572
Mailing Address - Fax:386-401-2356
Practice Address - Street 1:365 S MARION AVE STE 105
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-5233
Practice Address - Country:US
Practice Address - Phone:386-965-1572
Practice Address - Fax:386-401-2356
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty