Active NPI
Jetzabell Nortey Mayola
- Family Medicine Physician
- Plantation, FL
National Provider Identifier
1104562230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 11019250
- Practice address
- 201 NW 82ND Ave Ste 305
Plantation, FL 33324-1855 - Phone
- (954) 533-8353
- NPI assigned
- May 11, 2022
- Last updated
- May 11, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11019250 | FL | Primary |
Addresses
Primary practice location
201 NW 82ND Ave Ste 305
Plantation, FL 33324-1855
Mailing address
10320 SW 164TH St
Miami, FL 33157-3169
Phone (786) 218-2198
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11019250 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652227200000",
"number": "1104562230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10320 SW 164TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331573169",
"telephone_number": "786-218-2198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 NW 82ND AVE STE 305",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333241855",
"telephone_number": "954-533-8353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORTEY MAYOLA",
"first_name": "JETZABELL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-11",
"last_updated": "2022-05-11",
"certification_date": "2022-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "11019250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plantation, FL
- Non Surgical Center for Physical and Sports Medicine Inc
- Leiza Lee Norat Santiago
- Felipe Norena, DDS, MSD
- Carleen A Noreus, AGACNP-BC
- Sally S Noriega, ARNP
- North Broward Hospital District (BH Physicians Main)
- North Broward Hospital District (PWHC OBGYN)
- North Broward Hospital District (BH Urgent C are Plantation)
- North Broward Hospital District (BH Physicians Main)
- North Broward Hospital District (BH Physicians Main)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.