Healthcare Provider Details

I. General information

NPI: 1518893262
Provider Name (Legal Business Name): MAIA TAMAR WEISS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAIA TAMAR SALOMON

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 N FEDERAL HWY
BOCA RATON FL
33431-5187
US

IV. Provider business mailing address

4670 NE 5TH AVE APT 6
BOCA RATON FL
33431-5165
US

V. Phone/Fax

Practice location:
  • Phone: 425-279-3255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27877
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: