Provider Demographics
NPI:1437301645
Name:MIKHAIL, MARYANN (MD)
Entity Type:Individual
Prefix:
First Name:MARYANN
Middle Name:
Last Name:MIKHAIL
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 1:555 WASHINGTON AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-6639
Mailing Address - Country:US
Mailing Address - Phone:305-243-6704
Mailing Address - Fax:305-243-3503
Practice Address - Street 1:555 WASHINGTON AVE STE 210
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-6639
Practice Address - Country:US
Practice Address - Phone:305-243-6704
Practice Address - Fax:305-243-3503
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME141943207N00000X
NY251813207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology