Provider Demographics
NPI:1932769775
Name:ZLATKIN, NANCY ILENE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ILENE
Last Name:ZLATKIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 SW 9TH TER
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-2516
Mailing Address - Country:US
Mailing Address - Phone:954-695-5629
Mailing Address - Fax:
Practice Address - Street 1:1881 N UNIVERSITY DR STE 104
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6093
Practice Address - Country:US
Practice Address - Phone:954-340-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9172103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical