Provider Demographics
NPI:1659024073
Name:LIAT ZAKAY LLC
Entity Type:Organization
Organization Name:LIAT ZAKAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIAT
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAKAY
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:786-277-2797
Mailing Address - Street 1:600 KINGSMILL CV APT 110
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5839
Mailing Address - Country:US
Mailing Address - Phone:407-302-0089
Mailing Address - Fax:407-807-7500
Practice Address - Street 1:4725 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4603
Practice Address - Country:US
Practice Address - Phone:954-771-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty