Guillermo Maza Malave, MD is a medicare enrolled "Otolaryngology" physician in North Miami, Florida. His current practice location is
1801 Ne 123rd St Ste 315, North Miami, Florida. You can reach out to his office (for appointments etc.) via phone at
(786) 507-4151.
Guillermo Maza Malave is licensed to practice in Florida (license number ME173308) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1467947366.
Physician's Profile
Full Name | Guillermo Maza Malave |
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Gender | Male |
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Speciality | Otolaryngology |
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Location | 1801 Ne 123rd St Ste 315, North Miami, Florida |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1467947366
- Provider Enumeration Date: 06/25/2018
- Last Update Date: 08/26/2025
Medicare PECOS Information:
- PECOS PAC ID: 8820323066
- Enrollment ID: I20240605001982
Medical Identifiers
Medical identifiers for Guillermo Maza Malave such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1467947366 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Y00000X | Otolaryngology | 125074511 (Illinois) | Secondary |
207Y00000X | Otolaryngology | 328812 (New York) | Secondary |
207Y00000X | Otolaryngology | ME173308 (Florida) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Guillermo Maza Malave allows following entities to bill medicare on his behalf.
Entity Name | Icahn School Of Medicine At Mount Sinai |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1275802811 PECOS PAC ID: 2264691070 Enrollment ID: O20120315000035 |
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Entity Name | Icahn School Of Medicine At Mount Sinai |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1609120674 PECOS PAC ID: 8224282926 Enrollment ID: O20130205000439 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Guillermo Maza Malave is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Guillermo Maza Malave, MD 15280 Nw 79th Ct Ste 200, Miami Lakes, FL 33016-5873 Ph: (305) 558-3724 | Guillermo Maza Malave, MD 1801 Ne 123rd St Ste 315, North Miami, FL 33181-2883 Ph: (786) 507-4151 |
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