Provider Demographics
NPI:1275832032
Name:MISHAL, NATANYA MAIO (MD)
Entity Type:Individual
Prefix:DR
First Name:NATANYA
Middle Name:MAIO
Last Name:MISHAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NATANYA
Other - Middle Name:MICHELLE
Other - Last Name:MAIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3200 SW 60TH CT STE 302
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4071
Mailing Address - Country:US
Mailing Address - Phone:305-662-8330
Mailing Address - Fax:305-663-2813
Practice Address - Street 1:3200 SW 60TH CT STE 302
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155
Practice Address - Country:US
Practice Address - Phone:305-662-8330
Practice Address - Fax:305-663-2813
Is Sole Proprietor?:No
Enumeration Date:2011-03-19
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
FLME1281742084N0402X
CAA1260142084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program