MEDICARE: MAYA SMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	602466840222	OH

General Provider Information

NPI Number	:	1467154161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYA SMITH

Provider Business Mailing Address
First Line	:	3427 W 50TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-5809
Country	:	US
Telephone Number	:	216-541-0985
Fax Number	:

Provider Business Practice Location Address
First Line	:	3427 W 50TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-5809
Country	:	US
Telephone Number	:	216-541-0985
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2023
Last Update Date	:	03/20/2023

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Directions to “ MAYA SMITH ” Practice Location

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