Healthcare Provider Details

I. General information

NPI: 1962785907
Provider Name (Legal Business Name): MAYA BERENSON AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2011
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5608 PGA BLVD STE 206
PALM BEACH GARDENS FL
33418-4121
US

IV. Provider business mailing address

5608 PGA BLVD STE 206
PALM BEACH GARDENS FL
33418-4121
US

V. Phone/Fax

Practice location:
  • Phone: 561-500-3277
  • Fax:
Mailing address:
  • Phone: 561-500-3277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY1726
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number002359
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: