Provider Demographics
NPI:1508882283
Name:PRIETO, MARIA ISABEL (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ISABEL
Last Name:PRIETO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11760 SW 40TH ST
Mailing Address - Street 2:SUITE 347
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3582
Mailing Address - Country:US
Mailing Address - Phone:305-553-1663
Mailing Address - Fax:305-553-1786
Practice Address - Street 1:11760 SW 40TH ST
Practice Address - Street 2:SUITE 347
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3582
Practice Address - Country:US
Practice Address - Phone:305-553-1663
Practice Address - Fax:305-553-1786
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2013-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 0075082207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255855600Medicaid
FL255855600Medicaid