Basic Information
Provider Information
NPI: 1104234798
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZIKE
FirstName: ELIZABETH
MiddleName: MARIA
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 743144
Address2:  
City: ATLANTA
State: GA
PostalCode: 303743144
CountryCode: US
TelephoneNumber: 7865962000
FaxNumber: 3052797778
Practice Location
Address1: 8900 N KENDALL DR
Address2:  
City: MIAMI
State: FL
PostalCode: 331762118
CountryCode: US
TelephoneNumber: 7865962000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/26/2014
LastUpdateDate: 02/16/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/16/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X9171670FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
363LF0000XARNP 9171670FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363L00000XAPRN9171670FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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