Provider Demographics
NPI:1952401606
Name:AVELLA, ZORAIDA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ZORAIDA
Middle Name:
Last Name:AVELLA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:ZORAIDA
Other - Middle Name:
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1111 NE 25TH AVE
Mailing Address - Street 2:STE 504
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470
Mailing Address - Country:US
Mailing Address - Phone:352-351-2889
Mailing Address - Fax:352-351-9495
Practice Address - Street 1:1111 NE 25TH AVE
Practice Address - Street 2:STE 504
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470
Practice Address - Country:US
Practice Address - Phone:652-351-2889
Practice Address - Fax:352-351-9495
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW5567104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ8716Medicare ID - Type Unspecified