MEDICARE: ALAN RICHARD MAURER M.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	207X00000X	Orthopaedic Surgery Physician	ME16221	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00752859	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	146E9	OTHER	FL	BC/BS OF FLORIDA

General Provider Information

NPI Number	:	1780883892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN RICHARD MAURER M.D.

Provider Business Mailing Address
First Line	:	836 SUNSET LAKE BLVD
Second Line	:	SUITE 102
City	:	VENICE
State	:	FL
Zip	:	34292-7555
Country	:	US
Telephone Number	:	941-497-1771
Fax Number	:	941-497-1860

Provider Business Practice Location Address
First Line	:	836 SUNSET LAKE BLVD
Second Line	:	SUITE 102
City	:	VENICE
State	:	FL
Zip	:	24292-7555
Country	:	US
Telephone Number	:	941-966-9277
Fax Number	:	941-918-8668

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

Provider Enumeration Date	:	07/18/2007
Last Update Date	:	11/03/2009

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