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General NPI Number Information
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NPI Number | 1497205827
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Entity Type | Organization
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Legal Business Name | MLYM HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 10/10/2016
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Last Update Date | 10/10/2016
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Provider Practice Location Address
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Address Line | 19701 E LAKE DR
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City | HIALEAH
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State | FL
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Zip | 33015-2221
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Country | US
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Telephone | 305-335-1127
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Fax |
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Provider Business Mailing Address
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Address Line | 19701 E LAKE DR
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City | HIALEAH
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State | FL
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Zip | 33015-2221
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Country | US
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Telephone | 305-335-1127
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARGARITA L FABELO
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Credential | ARNP
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Telephone | 305-335-1127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 681692
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License Number State | FL
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