Healthcare Provider Details

I. General information

NPI: 1598991572
Provider Name (Legal Business Name): DAVID MAYO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2009
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10067 PINES BLVD STE B
PEMBROKE PINES FL
33024-6136
US

IV. Provider business mailing address

10067 PINES BLVD STE B
PEMBROKE PINES FL
33024-6136
US

V. Phone/Fax

Practice location:
  • Phone: 954-507-4494
  • Fax: 954-507-4515
Mailing address:
  • Phone: 954-507-4494
  • Fax: 954-504-4515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME167870
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: