Healthcare Provider Details
I. General information
NPI: 1972783165
Provider Name (Legal Business Name): MAURA CINTAS, M.D., PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/06/2007
Last Update Date: 08/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9000 SW 137TH AVE STE 204
MIAMI FL
33186-1436
US
IV. Provider business mailing address
9000 SW 137TH AVE STE 204
MIAMI FL
33186-1436
US
V. Phone/Fax
- Phone: 305-383-1902
- Fax: 305-383-9443
- Phone: 305-383-1902
- Fax: 305-383-9443
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | ME0062160 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
MAURA
CINTAS
Title or Position: DIRECTOR
Credential: MD
Phone: 305-383-1902