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General NPI Number Information
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NPI Number | 1679971881
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Entity Type | Individual
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Provider Name | MARIELI MILAGROS MAYORAL M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/22/2014
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Last Update Date | 04/02/2024
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Provider Practice Location Address
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Address Line | 7700 S DIXIE HWY
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City | WEST PALM BEACH
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State | FL
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Zip | 33405-4818
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Country | US
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Telephone | 561-720-2942
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Fax |
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Provider Business Mailing Address
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Address Line | 1732 S CONGRESS AVE STE 346
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City | PALM SPRINGS
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State | FL
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Zip | 33461-2140
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Country | US
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Telephone | 561-353-1225
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 18886
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License Number State | PR
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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 | ACN1034
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License Number State | FL
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