Healthcare Provider Details

I. General information

NPI: 1629032248
Provider Name (Legal Business Name): MAURY HURST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 W 84TH ST STE 31
HIALEAH FL
33014-3355
US

IV. Provider business mailing address

1550 W 84TH ST STE 31
HIALEAH FL
33014-3355
US

V. Phone/Fax

Practice location:
  • Phone: 59-011-1913
  • Fax: 786-292-6097
Mailing address:
  • Phone: 305-901-1191
  • Fax: 305-444-8079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME44903
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: