Healthcare Provider Details

I. General information

NPI: 1477482701
Provider Name (Legal Business Name): MARILEIVYS CAYMARES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E 25TH ST
HIALEAH FL
33013-3817
US

IV. Provider business mailing address

1090 SE 9TH CT APT 2
HIALEAH FL
33010-5837
US

V. Phone/Fax

Practice location:
  • Phone: 305-694-5400
  • Fax:
Mailing address:
  • Phone: 305-684-9855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3016
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: