Provider Demographics
NPI:1689373474
Name:CHAVES, ZAKARY K
Entity Type:Individual
Prefix:
First Name:ZAKARY
Middle Name:K
Last Name:CHAVES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13606 NW 9TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-2618
Mailing Address - Country:US
Mailing Address - Phone:786-746-2882
Mailing Address - Fax:
Practice Address - Street 1:13606 NW 9TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33182-2618
Practice Address - Country:US
Practice Address - Phone:786-746-2882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-257334106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician