Provider Demographics
NPI:1003877812
Name:MAYA, ALVARO (DMD)
Entity Type:Individual
Prefix:
First Name:ALVARO
Middle Name:
Last Name:MAYA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7775 SW 87TH AVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2536
Mailing Address - Country:US
Mailing Address - Phone:305-598-9072
Mailing Address - Fax:
Practice Address - Street 1:7775 SW 87TH AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2536
Practice Address - Country:US
Practice Address - Phone:305-598-9072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA187451223P0700X
FLDN173571223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics