Provider Demographics
NPI:1548835671
Name:GARBIN DE ZAYAS, MEILYN
Entity type:Individual
Prefix:MRS
First Name:MEILYN
Middle Name:
Last Name:GARBIN DE ZAYAS
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 1:8809 COVERED BRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1074
Mailing Address - Country:US
Mailing Address - Phone:305-849-8506
Mailing Address - Fax:
Practice Address - Street 1:8809 COVERED BRIDGE CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-1074
Practice Address - Country:US
Practice Address - Phone:305-849-8506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-21-162627106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician