Provider Demographics
NPI:1932135134
Name:ZAYAS-BAZAN, CARMEN ADELA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:ADELA
Last Name:ZAYAS-BAZAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11645 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 306-C
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3155
Mailing Address - Country:US
Mailing Address - Phone:305-891-6707
Mailing Address - Fax:305-891-1867
Practice Address - Street 1:11645 BISCAYNE BLVD
Practice Address - Street 2:SUITE 306-C
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3155
Practice Address - Country:US
Practice Address - Phone:305-891-6707
Practice Address - Fax:305-891-1867
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0003527103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL592823644Medicare UPIN
FL75580Medicare ID - Type Unspecified