Marytery Fajardo, M.D.

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

133163 Issued in FL

Practice address

3200 SW 60TH CT Ste 302
Miami, FL 33155-4071

Phone

(305) 662-8330

NPI assigned

May 3, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1083973572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SW 60TH CT STE 302",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331554071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SW 60TH CT STE 302",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331554071",
            "telephone_number": "305-662-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "MARYTERY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "FL",
            "license": "133163",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "FL",
            "license": "133163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marytery.fajardo@fcn.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "3200 SW 60th Ct Ste 302",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331554071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carmen G Fajardo, BS
• Diana M Fajardo
• Edgar Fajardo, LMT
• Marianela Fajardo, LCSW
• Martha Patricia Fajardo I
• Vanessa Fajardo
• Zara Fajardo, LMHC
• Maykel Fajo Reyes
• Wilfredo Fajo, LMT
• Jonathan Fakhry, MD

• Neurology with Special Qualifications in Child Neurology Physician in Miami, FL
• Providers in Miami, FL by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.