1750609442 NPI number — DR. MARICEL ZAYAS D.O

Table of content: DR. MARICEL ZAYAS D.O (NPI 1750609442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750609442 NPI number — DR. MARICEL ZAYAS D.O

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZAYAS
Provider First Name:
MARICEL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SOTO
Provider Other First Name:
MARICEL
Provider Other Middle Name:
ZAYAS
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DO
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1750609442
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1355 S INTERNATIONAL PKWY STE 1451
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE MARY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32746-1694
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-333-9888
Provider Business Mailing Address Fax Number:
407-333-9444

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2075 TOWN CTR BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32837-6803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-274-4313
Provider Business Practice Location Address Fax Number:
855-576-4910
Provider Enumeration Date:
05/06/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  OS14969 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: 0102203049 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: OS14969 . This is a "FL MEDICAL LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 0102203049 . This is a "VA MEDICAL LICENSE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 100201300 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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