Provider Demographics
NPI:1043034390
Name:COSTA, ZUHE VERONICA
Entity type:Individual
Prefix:
First Name:ZUHE
Middle Name:VERONICA
Last Name:COSTA
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 1:8903 PLUM GROVE CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1010
Mailing Address - Country:US
Mailing Address - Phone:813-895-4747
Mailing Address - Fax:
Practice Address - Street 1:3109 W DR MLK BLVD STE 500
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6220
Practice Address - Country:US
Practice Address - Phone:813-371-0549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24388077106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician