De La Maza, Antonio

De La Maza, Antonio is an sole proprietor health care provider with primary practice located at 10300 Sw 216Th St , Cutler Bay FL 33190-1003. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. De La Maza, Antonio can be contacted via phone (305) 278-6434.

Contact Information

Primary practice address
10300 Sw 216Th St Cutler Bay FL 33190-1003
Phone: (305) 278-6434
Fax: (305) 252-5881
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME# 0025026 Florida

Profile Details

NPI number 1619124898
LBN Legal business name De La Maza, Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 19th, 2008
Last updated Sep 30th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619124898 NPPES
Florida MEDICAID 001554300
Florida Other BCD & BS 2-29880 B

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