Provider Demographics
NPI:1982376869
Name:PAYAN, TAIMYS (ARNP)
Entity type:Individual
Prefix:
First Name:TAIMYS
Middle Name:
Last Name:PAYAN
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9740 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6252
Mailing Address - Country:US
Mailing Address - Phone:786-630-7725
Mailing Address - Fax:
Practice Address - Street 1:5740 NW 183RD ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-6021
Practice Address - Country:US
Practice Address - Phone:305-722-8565
Practice Address - Fax:305-722-8561
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-29
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11015009207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine