DR. MARY MAILLOUX (NPI# 1760485437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760485437 |
| Entity Type | Individual |
| Full Name | DR. MARY MAILLOUX |
| Credential | MD |
| Practice Address |
3333 W Commercial Blvd Ste 210 Ft Lauderdale FL 33309-3407 |
| Mailing Address |
4074 Sw 101st Ave Davie FL 33328-2205 |
| Practice Telephone | 8777511157 |
| Practice Fax Number | 9194251596 |
| Mailing Telephone | 9544765891 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2008-02-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | ME62993 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 374172900 | 05 | |
| FL | MEDICARE CORE | 23714 | 01 |
| Street Address |
3333 W COMMERCIAL BLVD STE 210 |
| City | FT LAUDERDALE |
| State | FL |
| Zip Code | 33309-3407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942841507 | Integrity Home Care Plus LLC | In Home Supportive Care | 1451 W Cypress Road Ste 300, Fort Lauderdale, FL 33309 | 2019-10-04 |
| 1518519875 | Jordanna Bettencourt | Behavior Technician | 1000 Sw 65th St, Suite #201, Fort Lauderdale, FL 33309 | 2019-07-16 |
| 1114579752 | Jewel Porter | Behavior Technician | 1000 Nw 65th St., Suite #201, Fort Lauderda, FL 33309 | 2019-07-14 |
| 1003318049 | Tri County Pet LLC | Clinic/Center | 2122 W. Cypress Creek Road, Suite 210, Fort Lauderdale, FL 33309 | 2018-03-06 |
| 1821508722 | Rose Marie Cecile Dyer | Home Health Aide | 4217 Nw 37th Terrace, Lauderdale Lakes, FL 33309 | 2017-10-05 |
| 1245756790 | Kattys Elena Mendoza | Behavior Technician | 1001 W. Cypress Creek Rd., 120, Ft Lauderdale, FL 33309 | 2017-08-16 |
| 1669902847 | Sharon Desir | Social Worker | 2700 West Cypress Creek Road, Executive Court, B-106, Fort Lauderdale, FL 33309 | 2017-06-19 |
| 1184158503 | Rebecca Robin Washington | Behavioral Analyst | 1001 W Cypress Creek Rd #120, Fort Lauderdale, Fl 33309, Fort Lauderdale, FL 33309 | 2017-04-12 |
| 1124564281 | Alloy Behavioral Health Solutions, Inc | Specialist | 1835 S Perimeter Road Suite 170, Fort Lauderdale, FL 33309 | 2017-01-13 |
| 1740738855 | Christina Camarena | Behavior Technician | 6414 Nw 5th Way, Fort Lauderdale, FL 33309 | 2016-09-18 |
| Find all providers in zip 33309 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700990215 | Richard Dellerson | Emergency Medicine | 1620 S Ocean Ln Apt 236, Ft Lauderdale, FL 33316-3327 | 2006-08-19 |
| 1578593232 | Sean M Tierney | Emergency Medicine | 6451 N Federal Hwy Ste 800, Ft Lauderdale, FL 33308-1409 | 2006-07-05 |
| 1184693400 | John L. Abt | Emergency Medicine | 9604 Southern Pines Court, Ft Lauderdale, FL 33328-6909 | 2006-03-17 |
| 1164495073 | Peter Freedland | Emergency Medicine | 5771 Bayview Dr, Ft Lauderdale, FL 33308-2830 | 2006-02-10 |
| 1700865433 | James Albert Staab | Emergency Medicine | 2901 Ne 26th Place, Ft Lauderdale, FL 33306 | 2006-01-11 |
| 1366431546 | Anita Renee Vander Heyden | Emergency Medicine | 1317 Mandarin Isle, Ft Lauderdale, FL 33315-1648 | 2005-10-19 |
| 1669468153 | Samuel Chukwuma | Emergency Medicine | 6401 N Federal Hwy, Imperial Point Ed, Ft Lauderdale, FL 33308-1405 | 2005-09-21 |
| 1518282714 | Stavros Papandreou | Emergency Medicine | 4109 N Federal Hwy, Ft Lauderdale, FL 33308-5530 | 2010-03-30 |
| 1457588618 | Peter Nicholas Gottschalk | Emergency Medicine | 6451 N Federal Hwy, Ste 800, Ft Lauderdale, FL 33308-1402 | 2009-06-16 |
| 1821234402 | Jean-paul O Sorondo | Emergency Medicine | 1600 S Andrews Ave, Ft Lauderdale, FL 33316-2510 | 2009-01-02 |
| Find all providers in FT LAUDERDALE | ||||
| City | FT LAUDERDALE |
| Zip Code | 33309 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.