Provider Demographics
NPI:1447933510
Name:ZABALLA PERERA, HANY MARGARITA
Entity type:Individual
Prefix:
First Name:HANY
Middle Name:MARGARITA
Last Name:ZABALLA PERERA
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 1:51 NW 56TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-2336
Mailing Address - Country:US
Mailing Address - Phone:786-754-2470
Mailing Address - Fax:
Practice Address - Street 1:51 NW 56TH ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-2336
Practice Address - Country:US
Practice Address - Phone:786-754-2470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-272582106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician