MEDICARE: MAYRA CAPOTE MD

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	208000000X	Pediatrics Physician	ME68714	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1972573319	OTHER	NPI
3	1861059248	OTHER	ORGANIZATIONAL NPI
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972573319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYRA CAPOTE MD

Provider Business Mailing Address
First Line	:	14400 NW 77TH CT STE 102
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-1590
Country	:	US
Telephone Number	:	305-823-7768
Fax Number	:	305-823-2211

Provider Business Practice Location Address
First Line	:	14400 NW 77TH CT STE 102
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-1590
Country	:	US
Telephone Number	:	305-823-7768
Fax Number	:	305-823-2211

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

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	01/09/2021

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Directions to “ MAYRA CAPOTE MD” Practice Location

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