Provider Demographics
NPI:1134213689
Name:ZAKEN-GREENBERG, FLORA JANE (PHD)
Entity type:Individual
Prefix:DR
First Name:FLORA
Middle Name:JANE
Last Name:ZAKEN-GREENBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 COUNTY ROAD 1
Mailing Address - Street 2:SUITE A
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-4655
Mailing Address - Country:US
Mailing Address - Phone:727-791-0886
Mailing Address - Fax:727-735-0359
Practice Address - Street 1:1201 COUNTY ROAD 1
Practice Address - Street 2:SUITE A
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-4655
Practice Address - Country:US
Practice Address - Phone:727-791-0886
Practice Address - Fax:727-735-0359
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0003863103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75906Medicare ID - Type UnspecifiedPSYCHOLOGIST