Individual provider · NPI-1

Maike Tiede Blaya, MD

Psychiatry & Neurology, Neurology · Hollywood, FL

NPI number1750583126
StatusActive
Last updated in NPPESMar 12, 2021

Details

NPI
1750583126
Entity type
Individual (NPI-1)
Name
Maike Tiede Blaya
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Jun 5, 2007
Certification date
Mar 12, 2021
Last updated
Mar 12, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084N0400X Psychiatry & Neurology, NeurologyME124225FLYes

Practice location

1150 N 35th Ave Ste 590
Hollywood, FL 33021

Phone 954-265-9500 · Fax 954-265-1431

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925

Phone 954-276-5685 · Fax 954-985-7074

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