Provider Demographics
NPI:1932326345
Name:ZAYAS, HENRY R (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:R
Last Name:ZAYAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 NW FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-9629
Mailing Address - Country:US
Mailing Address - Phone:772-878-5858
Mailing Address - Fax:772-692-2480
Practice Address - Street 1:1615 NW FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-9629
Practice Address - Country:US
Practice Address - Phone:772-878-5858
Practice Address - Fax:772-692-2480
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0058016174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV2628OtherBCBS
FLE83797Medicare UPIN
FLV2628OtherBCBS