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General NPI Number Information
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NPI Number | 1043553563
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Entity Type | Individual
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Provider Name | JARRED EVAN MAIT M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2013
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 925 W 41ST ST STE 300
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3339
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Country | US
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Telephone | 954-993-4587
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Fax | 786-231-5434
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Provider Business Mailing Address
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Address Line | 925 W 41ST ST STE 300
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3339
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Country | US
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Telephone | 954-993-4587
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Fax | 786-231-5434
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME 124911
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License Number State | FL
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