Healthcare Provider Details

I. General information

NPI: 1437665601
Provider Name (Legal Business Name): MARIELA D GAINZA MAYO APRN, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2017
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9408 SW 87TH AVE STE 102
MIAMI FL
33176-2416
US

IV. Provider business mailing address

9408 SW 87TH AVE STE 102
MIAMI FL
33176-2416
US

V. Phone/Fax

Practice location:
  • Phone: 833-769-3524
  • Fax:
Mailing address:
  • Phone: 833-769-3524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9365884
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number9365884
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: