Provider Demographics
NPI:1760417380
Name:MAYANS, MERCEDES J (DDS)
Entity Type:Individual
Prefix:DR
First Name:MERCEDES
Middle Name:J
Last Name:MAYANS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5333 COLLINS AVE APT 1202
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-5534
Mailing Address - Country:US
Mailing Address - Phone:305-993-5287
Mailing Address - Fax:305-267-3008
Practice Address - Street 1:6517 CORAL WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1843
Practice Address - Country:US
Practice Address - Phone:305-267-3377
Practice Address - Fax:305-267-3008
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0010110122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist