Healthcare Provider Details

I. General information

NPI: 1043649452
Provider Name (Legal Business Name): CL MEDICAL ASSOCIATES II INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2013
Last Update Date: 11/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PROFESSIONAL PARK DR
WEBSTER TX
77598-4127
US

IV. Provider business mailing address

200 CONGRESS PARK DR STE 100
DELRAY BEACH FL
33445-4618
US

V. Phone/Fax

Practice location:
  • Phone: 561-361-6608
  • Fax: 561-361-9857
Mailing address:
  • Phone: 561-361-6608
  • Fax: 561-361-9857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANNIE MAHARAJ
Title or Position: DIRECTOR OF PATIENT ACCOUNTS
Credential:
Phone: 561-361-6608