Healthcare Provider Details

I. General information

NPI: 1982376869
Provider Name (Legal Business Name): TAIMYS PAYAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5740 NW 183RD ST
HIALEAH FL
33015-6021
US

IV. Provider business mailing address

9740 JOHNSON ST
PEMBROKE PINES FL
33024-6252
US

V. Phone/Fax

Practice location:
  • Phone: 305-722-8565
  • Fax: 305-722-8561
Mailing address:
  • Phone: 786-630-7725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPRN11015009
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: