# LA MAISON MEDICAL PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275764698
- **Authorized official:** MAYLIN VALDES LMT (PRESIDENT)
- **Authorized official phone:** (305) 492-0010

## Contact information

- **Practice address:** 6595 NW 36 STREET, SUITE 200, MIAMI, FL 33166
- **Practice address phone:** (305) 492-0010
- **Practice address fax:** (305) 492-0011
- **Mailing address:** 6595 NW 36 STREET, SUITE 200, MIAMI, FL 33166
- **Mailing address phone:** (305) 492-0010
- **Mailing address fax:** (305) 492-0011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | MA49444 | FL | Yes |

## Other

- **Enumeration date:** 08/03/2009
- **Last updated:** 10/07/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | MA49444 | HEALTHCARE LICENSE | FL |