Provider Demographics
NPI:1962812529
Name:ANTON, MARIA TERESA (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:TERESA
Last Name:ANTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11233 SW 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-4609
Mailing Address - Country:US
Mailing Address - Phone:786-564-5813
Mailing Address - Fax:
Practice Address - Street 1:9965 64TH RD APT 5F
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2684
Practice Address - Country:US
Practice Address - Phone:786-564-5813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288307207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism