Healthcare Provider Details

I. General information

NPI: 1023037983
Provider Name (Legal Business Name): MARIA EUGENIA AMADOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1631 SW 107TH AVE
MIAMI FL
33165-7344
US

IV. Provider business mailing address

6100 BLUE LAGOON DR STE 365
MIAMI FL
33126-7010
US

V. Phone/Fax

Practice location:
  • Phone: 786-456-9005
  • Fax: 786-621-7814
Mailing address:
  • Phone: 786-322-7333
  • Fax: 786-347-5022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME94815
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: