Provider Demographics
NPI:1235913252
Name:MURCIA, MAURICIO ALEXANDER (CAA)
Entity Type:Individual
Prefix:
First Name:MAURICIO
Middle Name:ALEXANDER
Last Name:MURCIA
Suffix:
Gender:M
Credentials:CAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5263 N DIXIE HWY APT B1
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-7002
Mailing Address - Country:US
Mailing Address - Phone:954-638-9467
Mailing Address - Fax:
Practice Address - Street 1:5801 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5621
Practice Address - Country:US
Practice Address - Phone:954-638-9467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
367H00000X
FLAA863367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant