MEDICARE: MS. MARIA A MEDEROS ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	ARNP 2802932	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ARNP 2802932	OTHER	FL	MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316151780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIA A MEDEROS ARNP

Provider Business Mailing Address
First Line	:	2097 W 76TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-1834
Country	:	US
Telephone Number	:	786-504-5969
Fax Number	:

Provider Business Practice Location Address
First Line	:	2097 W 76TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-1834
Country	:	US
Telephone Number	:	786-504-5969
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	08/03/2020

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