Provider Demographics
NPI:1013314210
Name:MAYEDO PEREZ, MARYURI LAZARA (ARNP, NP-C)
Entity Type:Individual
Prefix:
First Name:MARYURI
Middle Name:LAZARA
Last Name:MAYEDO PEREZ
Suffix:
Gender:F
Credentials:ARNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9162 SW 153RD PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-2861
Mailing Address - Country:US
Mailing Address - Phone:786-227-0522
Mailing Address - Fax:
Practice Address - Street 1:11389 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1185
Practice Address - Country:US
Practice Address - Phone:786-227-0522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9323431363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily