Marytery Fajardo, M.D.
Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology in Miami, FL. Individual provider (NPI-1).
Details
- NPI
- 1083973572
- Entity type
- Individual (NPI-1)
- Name
- Marytery Fajardo
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 3, 2012
- Certification date
- Jul 14, 2022
- Last updated
- Jul 14, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology | 133163 | FL | Yes |
| 2084N0600X | 133163 | FL |
Practice location
3200 Sw 60th Ct Ste 302Miami, FL 33155-4071
Phone 305-662-8330
Mailing address
3200 Sw 60th Ct Ste 302Miami, FL 33155-4071
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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