MEDICARE: NATASHA HOME MAYA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372600000X	Adult Companion	236921	FL
2	376J00000X	Homemaker	236921	FL

General Provider Information

NPI Number	:	1386258978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA HOME MAYA

Provider Business Mailing Address
First Line	:	11730 SW 173RD ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-2229
Country	:	US
Telephone Number	:	305-988-2116
Fax Number	:

Provider Business Practice Location Address
First Line	:	11730 SW 173RD ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-2229
Country	:	US
Telephone Number	:	305-988-2116
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2020
Last Update Date	:	09/02/2020

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Directions to “ NATASHA HOME MAYA ” Practice Location

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