Fardales, Maricela Dianexi

Fardales, Maricela Dianexi is an individual health care provider with primary practice located at 8051 W 24Th Ave Ste 9 , Hialeah FL 33016-5596. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Fardales, Maricela Dianexi can be contacted via phone (305) 400-9702.

Contact Information

Primary practice address
8051 W 24Th Ave Ste 9 Hialeah FL 33016-5596
Phone: (305) 400-9702
Fax: (305) 735-7542
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9103093 Florida

Profile Details

NPI number 1457362410
LBN Legal business name Fardales, Maricela Dianexi
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Jul 13th, 2021 - about 3 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 1457362410 NPPES
Florida MEDICAID 004570500

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