Provider Demographics
NPI:1861985525
Name:ZEPHIR, LOURDES
Entity type:Individual
Prefix:
First Name:LOURDES
Middle Name:
Last Name:ZEPHIR
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 1:13990 NE 6TH AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-3153
Mailing Address - Country:US
Mailing Address - Phone:954-483-5267
Mailing Address - Fax:
Practice Address - Street 1:1360 NW 130TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33167-1714
Practice Address - Country:US
Practice Address - Phone:954-483-5267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL822587848Medicaid