Healthcare Provider Details

I. General information

NPI: 1902016827
Provider Name (Legal Business Name): MILITZA I MIZRAY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E CYPRESS DR
PEMBROKE PINES FL
33025-4543
US

IV. Provider business mailing address

2725 NE 8TH AVE
WILTON MANORS FL
33334-2631
US

V. Phone/Fax

Practice location:
  • Phone: 305-702-7776
  • Fax:
Mailing address:
  • Phone: 305-702-7776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number189597
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: