MEDICARE: DR. MARIELI MILAGROS MAYORAL M.D.

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	208D00000X	General Practice Physician	18886	PR
2	208D00000X	General Practice Physician	ACN1034	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ACN1034	OTHER	FL	STATE OF FLORIDA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679971881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIELI MILAGROS MAYORAL M.D.

Provider Business Mailing Address
First Line	:	1732 S CONGRESS AVE STE 346
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-2140
Country	:	US
Telephone Number	:	561-353-1225
Fax Number	:

Provider Business Practice Location Address
First Line	:	7700 S DIXIE HWY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-4818
Country	:	US
Telephone Number	:	561-720-2942
Fax Number	:

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

Provider Enumeration Date	:	12/22/2014
Last Update Date	:	04/02/2024

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