MEDICARE: DANIEL J MAUER PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PY9330	FL

General Provider Information

NPI Number	:	1164484937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL J MAUER PH.D.

Provider Business Mailing Address
First Line	:	3200 NE 10TH ST APT 1
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-3947
Country	:	US
Telephone Number	:	443-777-7878
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 NE 10TH ST APT 1
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-3947
Country	:	US
Telephone Number	:	410-746-6530
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	02/15/2022

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