Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marissa Lum

Individual provider Physician Assistant · NPI 1679138895

Marissa Lum is a Physician Assistant in Miami Shores, Florida. Qualified in 2023, 3 years ago. Practices with Maimonides Faculty Practice Plan, a 246-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2019
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Practice location Address checks out

11300 NE 2nd Ave
Miami Shores, FL 33161-6628
Phone: (305) 899-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1679138895
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 2, 2019
Last updated in NPPESJanuary 17, 2024
Certification dateJanuary 17, 2024
Mailing address11300 Ne 2nd Ave, Miami Shores, FL 33161-6628

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Maimonides Faculty Practice Plan — 246 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Miami Shores