Basic Information
| Provider Information | |||||||||
| NPI: | 1306260575 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NAIDAS | ||||||||
| FirstName: | MARLON | ||||||||
| MiddleName: | DAVIS PAPA | ||||||||
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| Credential: | R.N., L.M.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11919 SW 154TH AVE | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331966828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058156335 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1201 NW 16TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331251624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055757000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2014 | ||||||||
| LastUpdateDate: | 02/09/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN9366139 | FL | Y | Nursing Service Providers | Registered Nurse |
No ID Information.