Healthcare Provider Details

I. General information

NPI: 1568150050
Provider Name (Legal Business Name): MAUCLAIR CAJUSTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1529 BENZ TER
SEBRING FL
33872-2802
US

IV. Provider business mailing address

1529 BENZ TER
SEBRING FL
33872-2802
US

V. Phone/Fax

Practice location:
  • Phone: 863-414-7298
  • Fax:
Mailing address:
  • Phone: 863-414-7298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberTRN36852
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: