Provider Demographics
NPI:1770907743
Name:JOAQUIN S MAURY MD PA
Entity type:Organization
Organization Name:JOAQUIN S MAURY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JOAQUIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MAURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-702-9441
Mailing Address - Street 1:8200 SW 117TH AVE STE 416
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4828
Mailing Address - Country:US
Mailing Address - Phone:786-409-7662
Mailing Address - Fax:786-409-5881
Practice Address - Street 1:8200 SW 117TH AVE STE 416
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4828
Practice Address - Country:US
Practice Address - Phone:786-409-7662
Practice Address - Fax:786-409-5881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME117409208VP0014X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty