Provider Demographics
NPI:1114257797
Name:HACHE, MARIA J (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:J
Last Name:HACHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:J
Other - Last Name:PEREZ-MENDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 260211
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-7211
Mailing Address - Country:US
Mailing Address - Phone:305-455-7437
Mailing Address - Fax:
Practice Address - Street 1:6161 SUNSET DR STE B
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5045
Practice Address - Country:US
Practice Address - Phone:305-455-7437
Practice Address - Fax:305-455-7435
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2020-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN350208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004259200Medicaid
FLFK480ZMedicare UPIN