Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | ME 124911 | FL |
NPI | 1043553563 |
---|---|
Provider Name | Dr. Jarred Evan Mait |
First Address | Miami Beach, FL 33140-3339 |
Second Address | Miami Beach, FL 33140-3339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2013 |
Last Update Date | 16/11/2021 |