Mayorga-Vasquez, Martha L

Mayorga-Vasquez, Martha L is an sole proprietor health care provider with primary practice located at 18503 Pines Blvd Ste 212 , Pembroke Pines FL 33029-1405. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mayorga-Vasquez, Martha L can be contacted via phone (954) 392-0266.

Contact Information

Primary practice address
18503 Pines Blvd Ste 212 Pembroke Pines FL 33029-1405
Fax: (954) 392-0267
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME66599 Florida

Profile Details

NPI number 1376530196
LBN Legal business name Mayorga-Vasquez, Martha L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 6th, 2005
Last updated Mar 26th, 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 1376530196 NPPES
Florida MEDICAID 258309700

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