MEDICARE: FRED MAJAVA

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	227900000X	Registered Respiratory Therapist	RT4412	FL

General Provider Information

NPI Number	:	1366874943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRED MAJAVA

Provider Business Mailing Address
First Line	:	5811 NE 21ST DR
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-2511
Country	:	US
Telephone Number	:	954-562-6334
Fax Number	:

Provider Business Practice Location Address
First Line	:	5811 NE 21ST DR
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-2511
Country	:	US
Telephone Number	:	954-562-6334
Fax Number	:

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

Provider Enumeration Date	:	08/06/2013
Last Update Date	:	08/06/2013

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Directions to “ FRED MAJAVA ” Practice Location

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