Healthcare Provider Details

I. General information

NPI: 1396942017
Provider Name (Legal Business Name): PATRICIA ANN MAYER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 10/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 CLEVELAND CLINIC BLVD
WESTON FL
33331-3609
US

IV. Provider business mailing address

6644 E BAYWOOD AVE
MESA AZ
85206-1797
US

V. Phone/Fax

Practice location:
  • Phone: 954-689-5000
  • Fax:
Mailing address:
  • Phone: 480-321-3900
  • Fax: 480-321-3840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number16643
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number16643
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: