Healthcare Provider Details

I. General information

NPI: 1689503575
Provider Name (Legal Business Name): LYNN MERDORA MAURASSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

276 NE 110TH ST
MIAMI FL
33161-7017
US

IV. Provider business mailing address

276 NE 110TH ST
MIAMI FL
33161-7017
US

V. Phone/Fax

Practice location:
  • Phone: 941-592-0032
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: