Provider Demographics
NPI:1073973269
Name:MIESES, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MIESES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 GOLDEN ISLES DR APT 2F
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7561
Mailing Address - Country:US
Mailing Address - Phone:954-295-7135
Mailing Address - Fax:
Practice Address - Street 1:450 GOLDEN ISLES DR APT 2F
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-7561
Practice Address - Country:US
Practice Address - Phone:954-295-7135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health