Healthcare Provider Details

I. General information

NPI: 1780507525
Provider Name (Legal Business Name): MAYRA E AVELAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W 49TH ST STE 332
HIALEAH FL
33012-3489
US

IV. Provider business mailing address

900 W 49TH ST STE 332
HIALEAH FL
33012-3489
US

V. Phone/Fax

Practice location:
  • Phone: 786-521-3071
  • Fax: 786-789-5315
Mailing address:
  • Phone: 786-789-5305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA20652
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: