Individual
MARTHA L MAYORGA-VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
18503 PINES BLVD STE 212, PEMBROKE PINES, FL 33029-1405
(954) 392-0266
(954) 392-0267
Mailing address
18503 PINES BLVD STE 212, PEMBROKE PINES, FL 33029-1405
(954) 392-0266
(954) 392-0267
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME66599
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258309700
—
FL
Enumeration date
10/06/2005
Last updated
03/26/2021
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