Provider Demographics
NPI:1083977995
Name:MAYBIT-PASKER, LUIS
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:MAYBIT-PASKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:LUIS
Other - Middle Name:
Other - Last Name:MAYBIT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:14540 CORTEZ BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-6001
Mailing Address - Country:US
Mailing Address - Phone:352-597-8287
Mailing Address - Fax:
Practice Address - Street 1:14540 CORTEZ BLVD STE 108
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-6001
Practice Address - Country:US
Practice Address - Phone:352-597-8287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE26644207V00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology