Provider Demographics
NPI:1609986199
Name:FIGUEROA, MAYTE IDELIZ (MD)
Entity Type:Individual
Prefix:DR
First Name:MAYTE
Middle Name:IDELIZ
Last Name:FIGUEROA
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:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-454-6095
Mailing Address - Fax:314-454-2561
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:DIV PED CARDIOLOGY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-6095
Practice Address - Fax:314-454-2561
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016000803208000000X, 2080P0203X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205590607Medicaid
ILENROLLEDMedicaid
TX00U87ZOtherBCBSTX GRP PIN
TX1624728OtherFIRSTHEALTH PIN
TX162849702Medicaid
TX00U87ZMedicare PIN
1750369203OtherGRP NPI NUMBER
TX124137OtherSUPERIOR PIN
TX2055144OtherUHC PIN
TX3417149OtherAETNA PIN
TX8F3703OtherBCBSTX IND PIN
TX137345810Medicaid
TX937061OtherPRONET PIN
G34418Medicare UPIN
TX10012006OtherAMERIGROUP PIN
TX136704100OtherFIRSTCARE PIN
TX7283908OtherCIGNA PIN
TX162849701Medicaid