MEDICARE: DR. MICHAEL E MAHLA MD

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	207L00000X	Anesthesiology Physician	ME45109	FL
2	207L00000X	Anesthesiology Physician	MD453812	PA
3	207L00000X	Anesthesiology Physician	ME151584	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962420828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL E MAHLA MD

Provider Business Mailing Address
First Line	:	1400 NW 10TH AVE STE 1104A
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1000
Country	:	US
Telephone Number	:	305-243-3828
Fax Number	:	305-243-0143

Provider Business Practice Location Address
First Line	:	1400 NW 10TH AVE STE 1104A
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1000
Country	:	US
Telephone Number	:	305-243-3828
Fax Number	:	305-243-0143

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	08/11/2022

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Directions to “ DR. MICHAEL E MAHLA MD” Practice Location

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