=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821226077
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARITECH SYSTEMS, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2009
-----------------------------------------------------
Last Update Date | 06/26/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20911 JOHNSON ST SUITE 132
-----------------------------------------------------
City | PEMBROKE PINES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33029-2188
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-447-1200
-----------------------------------------------------
Fax | 954-447-8558
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20911 JOHNSON ST SUITE 132
-----------------------------------------------------
City | PEMBROKE PINES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33029-2188
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-447-1200
-----------------------------------------------------
Fax | 954-447-8558
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | STEVEN ZUCKER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-447-1200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333300000X
-----------------------------------------------------
Taxonomy Name | Emergency Response System Companies
-----------------------------------------------------
License Number | EF20000581
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------