Provider Demographics
NPI:1336668763
Name:KYRIACOU, MARIA NATALIE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:NATALIE
Last Name:KYRIACOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15955 SW 96TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1271
Mailing Address - Country:US
Mailing Address - Phone:786-467-3430
Mailing Address - Fax:786-533-9695
Practice Address - Street 1:15955 SW 96TH ST STE 402
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1273
Practice Address - Country:US
Practice Address - Phone:786-467-3430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-18
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8587207Q00000X
FLME141195207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine