Provider Demographics
NPI:1639663602
Name:OPEL, MARIAM MASOOD (MD)
Entity Type:Individual
Prefix:
First Name:MARIAM
Middle Name:MASOOD
Last Name:OPEL
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 1:1611 NW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1005
Mailing Address - Country:US
Mailing Address - Phone:305-585-6683
Mailing Address - Fax:305-324-6012
Practice Address - Street 1:1611 NW 12TH AVE # WING109
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-585-6683
Practice Address - Fax:305-324-6012
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program