Provider Demographics
NPI:1356734487
Name:RESENDEZ, ZARAH
Entity type:Individual
Prefix:
First Name:ZARAH
Middle Name:
Last Name:RESENDEZ
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 1:7351 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-7107
Mailing Address - Country:US
Mailing Address - Phone:954-749-6955
Mailing Address - Fax:954-578-2783
Practice Address - Street 1:7351 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-7107
Practice Address - Country:US
Practice Address - Phone:954-748-2500
Practice Address - Fax:954-749-6311
Is Sole Proprietor?:No
Enumeration Date:2015-03-13
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105741363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical