Healthcare Provider Details

I. General information

NPI: 1811555139
Provider Name (Legal Business Name): RAISA AMELIA MAYERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2019
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11211 PROSPERITY FARMS RD
PALM BEACH GARDENS FL
33410-3446
US

IV. Provider business mailing address

11211 PROSPERITY FARMS RD STE C113
PALM BEACH GARDENS FL
33410-3454
US

V. Phone/Fax

Practice location:
  • Phone: 561-626-9041
  • Fax:
Mailing address:
  • Phone: 561-626-9041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberME166844
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: