Provider Demographics
NPI:1811534258
Name:ZAPATA MARTIN, MARIA DANIELA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DANIELA
Last Name:ZAPATA MARTIN
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 1:12615 NW 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33167-1574
Mailing Address - Country:US
Mailing Address - Phone:786-370-0709
Mailing Address - Fax:
Practice Address - Street 1:2499 GLADES RD STE 104
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7260
Practice Address - Country:US
Practice Address - Phone:561-350-8592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-23-65691103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst