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Provider Information for 1639572472


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ZELIMNA TAVERAS MS, LMHC


Sex: Female

NPI: 1639572472
Last Updated: 2024-05-10
Certification Date: 2024-05-10

Details

NameValue
NPI1639572472
Enumeration Date2014-10-08
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 2201 NW CORPORATE BLVD STE 101
BOCA RATON, FL 33431-7337
United States

Phone: 561-617-8751 | Fax:561-423-0711
 
Primary Practice Address 2201 NW CORPORATE BLVD STE 101
BOCA RATON, FL 33431-7337
United States

Phone: 561-617-8751 | Fax:561-423-0711
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 104100000X - Social Worker
Yes 101YM0800X - Counselor - Mental HealthFLMH17344