Healthcare Provider Details

I. General information

NPI: 1205720802
Provider Name (Legal Business Name): MARIA DEL MILAGRO ESTRADA FUNEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 EAST 149TH STREET, ROOM 4-20, BRONX
NEW YORK CITY NY
10451
US

IV. Provider business mailing address

234 EAST 149TH STREET, ROOM 4-20, BRONX
NEW YORK CITY NY
10451
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-5030
  • Fax:
Mailing address:
  • Phone: 504-943-4688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: