Provider Demographics
NPI:1225276769
Name:MAURICE, THAMAR (FNP)
Entity Type:Individual
Prefix:
First Name:THAMAR
Middle Name:
Last Name:MAURICE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 W FLAGLER ST FL 9
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-1887
Mailing Address - Country:US
Mailing Address - Phone:305-490-6797
Mailing Address - Fax:
Practice Address - Street 1:66 W FLAGLER ST FL 9
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-1887
Practice Address - Country:US
Practice Address - Phone:305-490-6797
Practice Address - Fax:305-317-5284
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5182385164W00000X
FL11003272363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No164W00000XNursing Service ProvidersLicensed Practical Nurse