Provider Demographics
NPI:1942976949
Name:DACCACH ZENCK, ANA C
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:C
Last Name:DACCACH ZENCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 BRICKELL BAY DR APT 3001
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3241
Mailing Address - Country:US
Mailing Address - Phone:832-857-4719
Mailing Address - Fax:
Practice Address - Street 1:2009 SW 9TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-3323
Practice Address - Country:US
Practice Address - Phone:305-632-3359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA20601235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist