Provider Demographics
NPI:1770815201
Name:ZAKAI, MILES (MA,)
Entity type:Individual
Prefix:
First Name:MILES
Middle Name:
Last Name:ZAKAI
Suffix:
Gender:M
Credentials:MA,
Other - Prefix:MR
Other - First Name:MILES
Other - Middle Name:
Other - Last Name:ZAKAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA,
Mailing Address - Street 1:315 N LAKEMONT AVE STE B
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3205
Mailing Address - Country:US
Mailing Address - Phone:407-830-6412
Mailing Address - Fax:
Practice Address - Street 1:315 N LAKEMONT AVE STE B
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3205
Practice Address - Country:US
Practice Address - Phone:407-830-6412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH7038101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health