Provider Demographics
NPI:1114815081
Name:BAYONNE, ZACHER
Entity type:Individual
Prefix:MR
First Name:ZACHER
Middle Name:
Last Name:BAYONNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 4TH ST N STE 300
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4399
Mailing Address - Country:US
Mailing Address - Phone:301-573-0875
Mailing Address - Fax:
Practice Address - Street 1:1520 TUBMAN RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2958
Practice Address - Country:US
Practice Address - Phone:301-573-0875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral