Provider Demographics
NPI:1629032248
Name:HURST, MAURY (MD)
Entity Type:Individual
Prefix:
First Name:MAURY
Middle Name:
Last Name:HURST
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 1:1834 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2453
Mailing Address - Country:US
Mailing Address - Phone:305-444-8574
Mailing Address - Fax:305-444-8079
Practice Address - Street 1:4908 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2439
Practice Address - Country:US
Practice Address - Phone:305-444-8574
Practice Address - Fax:305-444-8079
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME44903207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069557200Medicaid
FL96581OtherMEDICARE
FL069557200Medicaid