Provider Demographics
NPI:1336401090
Name:ZAK, SARAH T (AU D)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:T
Last Name:ZAK
Suffix:
Gender:F
Credentials:AU D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 DR. MLK JR. STREET NORTH
Mailing Address - Street 2:STE. 108
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-1547
Mailing Address - Country:US
Mailing Address - Phone:727-456-3288
Mailing Address - Fax:727-456-3289
Practice Address - Street 1:1033 DR. MLK JR. STREET NORTH
Practice Address - Street 2:STE. 108
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-1547
Practice Address - Country:US
Practice Address - Phone:727-456-3288
Practice Address - Fax:727-456-3289
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1240231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist