Provider Demographics
NPI:1639443732
Name:DEPAZ, ZAYDA C (RPH)
Entity Type:Individual
Prefix:
First Name:ZAYDA
Middle Name:C
Last Name:DEPAZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8460 SW 80TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7041
Mailing Address - Country:US
Mailing Address - Phone:305-281-4597
Mailing Address - Fax:
Practice Address - Street 1:5321 W 20TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2100
Practice Address - Country:US
Practice Address - Phone:305-364-9100
Practice Address - Fax:305-364-9363
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS17916183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist