Provider Demographics
NPI:1912311804
Name:MARIA JJAIME MD PA
Entity type:Organization
Organization Name:MARIA JJAIME MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:JAIME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-890-0109
Mailing Address - Street 1:950 N KROME AVE
Mailing Address - Street 2:SUITE 408
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4400
Mailing Address - Country:US
Mailing Address - Phone:786-890-0109
Mailing Address - Fax:
Practice Address - Street 1:950 N KROME AVE
Practice Address - Street 2:SUITE 408
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4400
Practice Address - Country:US
Practice Address - Phone:786-890-0109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZME111905207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty