Basic Information
Provider Information
NPI: 1336456888
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZENLEA
FirstName: SARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 S PINE ISLAND RD
Address2: SUITE 230
City: PLANTATION
State: FL
PostalCode: 333242613
CountryCode: US
TelephoneNumber: 9543702140
FaxNumber: 9549161252
Practice Location
Address1: 100 S PINE ISLAND RD
Address2: SUITE 230
City: PLANTATION
State: FL
PostalCode: 333242613
CountryCode: US
TelephoneNumber: 9543702140
FaxNumber: 9549161252
Other Information
ProviderEnumerationDate: 09/03/2010
LastUpdateDate: 09/03/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XSW9743FLY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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