Provider Demographics
NPI:1912882028
Name:ZAPATA HERNANDEZ, TANYA LEE
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:LEE
Last Name:ZAPATA HERNANDEZ
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 1:1349 CALLE SALUD STE 3
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-2017
Mailing Address - Country:US
Mailing Address - Phone:787-840-7747
Mailing Address - Fax:
Practice Address - Street 1:1349 CALLE SALUD
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-2017
Practice Address - Country:US
Practice Address - Phone:787-840-7747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRRBT-23-299379106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty