Provider Demographics
NPI:1548211204
Name:MANIAR, MAYUR (MD)
Entity Type:Individual
Prefix:
First Name:MAYUR
Middle Name:
Last Name:MANIAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6245 N FEDERAL HWY
Mailing Address - Street 2:300
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-1998
Mailing Address - Country:US
Mailing Address - Phone:954-956-1966
Mailing Address - Fax:954-745-0501
Practice Address - Street 1:3540 N PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6637
Practice Address - Country:US
Practice Address - Phone:954-321-1776
Practice Address - Fax:954-321-1878
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00512602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL058575100Medicaid
FL05984Medicare ID - Type Unspecified
FLD51461Medicare UPIN