Healthcare Provider Details

I. General information

NPI: 1659782654
Provider Name (Legal Business Name): MARIA FACADIO ANTERO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 PONCE DE LEON BLVD STE 110
CORAL GABLES FL
33146-1842
US

IV. Provider business mailing address

4425 PONCE DE LEON BLVD STE 110
CORAL GABLES FL
33146-1842
US

V. Phone/Fax

Practice location:
  • Phone: 305-446-4673
  • Fax:
Mailing address:
  • Phone: 305-446-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD84882
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberME148030
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: