Provider Demographics
NPI:1578264222
Name:BADA, MAYRELIS (FNP-C, APRN)
Entity Type:Individual
Prefix:
First Name:MAYRELIS
Middle Name:
Last Name:BADA
Suffix:
Gender:F
Credentials:FNP-C, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9540 MARTINIQUE DR
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1732
Mailing Address - Country:US
Mailing Address - Phone:954-995-9176
Mailing Address - Fax:
Practice Address - Street 1:9540 MARTINIQUE DR
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1732
Practice Address - Country:US
Practice Address - Phone:954-995-9176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11025181207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine