Healthcare Provider Details

I. General information

NPI: 1114855970
Provider Name (Legal Business Name): MYA HEALTH CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S DIXIE HWY STE 4E
CORAL GABLES FL
33146-2232
US

IV. Provider business mailing address

13499 BISCAYNE BLVD APT 1702
NORTH MIAMI FL
33181-2031
US

V. Phone/Fax

Practice location:
  • Phone: 754-201-5336
  • Fax: 786-206-7010
Mailing address:
  • Phone: 754-201-5336
  • Fax: 786-206-7010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN CERA LOPEZ
Title or Position: OWNER
Credential:
Phone: 754-201-5336