Provider Demographics
NPI:1518592708
Name:COMAS, MARIA ELSIE
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ELSIE
Last Name:COMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10833 NW 83RD ST UNIT 4
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1686
Mailing Address - Country:US
Mailing Address - Phone:786-683-8966
Mailing Address - Fax:
Practice Address - Street 1:10833 NW 83RD ST UNIT 4
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-1686
Practice Address - Country:US
Practice Address - Phone:786-683-8966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-08
Last Update Date:2020-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11006431363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty