Individual
MAYULI DIAZ HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
14050 SW 91ST TER, MIAMI, FL 33186-1293
(786) 854-0240
Mailing address
14050 SW 91ST TER, MIAMI, FL 33186-1293
(786) 854-0240
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
25-296
FL
363A00000X
Physician Assistant
2977
PR
363AS0400X
Surgical Physician Assistant
2977
PR
Other
Enumeration date
12/08/2025
Last updated
12/08/2025
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