Healthcare Provider Details

I. General information

NPI: 1790614097
Provider Name (Legal Business Name): MAYFAIRE MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 CLEVELAND AVE SW STE 410
ATLANTA GA
30315-7119
US

IV. Provider business mailing address

8390 W FLAGLER ST STE 201
MIAMI FL
33144-2039
US

V. Phone/Fax

Practice location:
  • Phone: 305-747-3846
  • Fax: 305-717-7593
Mailing address:
  • Phone: 305-747-3846
  • Fax: 305-717-7593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY MARCIANTE
Title or Position: CLINIC MANAGER
Credential:
Phone: 305-747-3846