MEDICARE: DR. MADHURIE MAHARAJ PHARM D

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	1835P1200X	Pharmacotherapy Pharmacist	PS 26888	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PU 4406	OTHER	FL	FL CONSULTANT LICENSE NUM
2	PS 26888	OTHER	FL	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1659341683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MADHURIE MAHARAJ PHARM D

Provider Business Mailing Address
First Line	:	1204 CANYON WAY
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-3142
Country	:	US
Telephone Number	:	561-333-2054
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 W BROWARD BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33312-1638
Country	:	US
Telephone Number	:	954-527-6061
Fax Number	:	954-467-9587

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

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	07/08/2007

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