Healthcare Provider Details

I. General information

NPI: 1235239351
Provider Name (Legal Business Name): PAUL W MAURER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 11/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3708 N ROOSEVELT BLVD
KEY WEST FL
33040-4533
US

IV. Provider business mailing address

3708 N ROOSEVELT BLVD
KEY WEST FL
33040-4533
US

V. Phone/Fax

Practice location:
  • Phone: 305-296-1097
  • Fax: 305-296-8532
Mailing address:
  • Phone: 305-296-1097
  • Fax: 305-296-8532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME65103
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: