1912755471 NPI number — MARIA CLAUDIA MAURICIO MD

Table of content: MARIA CLAUDIA MAURICIO MD (NPI 1912755471)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912755471 NPI number — MARIA CLAUDIA MAURICIO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAURICIO
Provider First Name:
MARIA
Provider Middle Name:
CLAUDIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912755471
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/30/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
01/10/2025
NPI Reactivation Date:
01/30/2025

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 ANTILLA AVE, CORAL GABLES
Provider Second Line Business Mailing Address:
APT 4
Provider Business Mailing Address City Name:
CORAL GABLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-747-2553
Provider Business Mailing Address Fax Number:
305-325-1282

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1611 NW 12 AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-585-1111
Provider Business Practice Location Address Fax Number:
305-325-1282
Provider Enumeration Date:
05/09/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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