Provider Demographics
NPI:1851277248
Name:PLAZA RINCON, MARIANYELA (PA)
Entity type:Individual
Prefix:
First Name:MARIANYELA
Middle Name:
Last Name:PLAZA RINCON
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 1:20355 NE 34TH CT APT 721
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3312
Mailing Address - Country:US
Mailing Address - Phone:786-247-3149
Mailing Address - Fax:
Practice Address - Street 1:20355 NE 34TH CT APT 721
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-3312
Practice Address - Country:US
Practice Address - Phone:786-247-3149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2387-P.A.363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant