Provider Demographics
NPI:1780371518
Name:GYOREV, MARIYA (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARIYA
Middle Name:
Last Name:GYOREV
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MARIYA
Other - Middle Name:
Other - Last Name:NESTOROVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:4040 W PALM AIRE DR
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-4193
Mailing Address - Country:US
Mailing Address - Phone:954-516-2824
Mailing Address - Fax:
Practice Address - Street 1:4040 W PALM AIRE DR
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-4193
Practice Address - Country:US
Practice Address - Phone:224-600-0002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY11721103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical