Provider Demographics
NPI:1629002571
Name:MARIAINES APOLO PA
Entity type:Organization
Organization Name:MARIAINES APOLO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIAINES
Authorized Official - Middle Name:
Authorized Official - Last Name:APOLO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-322-8629
Mailing Address - Street 1:251 VALENCIA AVE UNIT 142133
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-6987
Mailing Address - Country:US
Mailing Address - Phone:305-459-3970
Mailing Address - Fax:305-459-3971
Practice Address - Street 1:8339 NW 12TH ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1841
Practice Address - Country:US
Practice Address - Phone:305-459-3970
Practice Address - Fax:305-459-3971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3228213ES0131X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty