Provider Demographics
NPI:1265196281
Name:ALDOSSARY, MARYAM ABDULLAH H (RN)
Entity type:Individual
Prefix:MISS
First Name:MARYAM
Middle Name:ABDULLAH H
Last Name:ALDOSSARY
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:201 SE 2ND AVE APT 2521
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2260
Mailing Address - Country:US
Mailing Address - Phone:312-721-0364
Mailing Address - Fax:
Practice Address - Street 1:201 SE 2ND AVE APT 2521
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2260
Practice Address - Country:US
Practice Address - Phone:312-721-0364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2021-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL9510472163W00000X
FL11016301363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty