Provider Demographics
NPI:1902974637
Name:CHERUBIN, MAYMONE (PA)
Entity Type:Individual
Prefix:MS
First Name:MAYMONE
Middle Name:
Last Name:CHERUBIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3090 S.W. 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4311
Mailing Address - Country:US
Mailing Address - Phone:305-351-1320
Mailing Address - Fax:305-444-7866
Practice Address - Street 1:3090 S DOUGLAS RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4311
Practice Address - Country:US
Practice Address - Phone:305-351-1320
Practice Address - Fax:305-444-7866
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical