MEDICARE: MAIA WASKUCH

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	2355S0801X	Speech-Language Assistant	SI7769	FL
2	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1528947686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAIA WASKUCH

Provider Business Mailing Address
First Line	:	1210 BUCKHEAD DR SW
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32968-5088
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1210 BUCKHEAD DR SW
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32968-5088
Country	:	US
Telephone Number	:	772-538-9877
Fax Number	:

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

Provider Enumeration Date	:	09/01/2025
Last Update Date	:	01/12/2026

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Directions to “ MAIA WASKUCH ” Practice Location

Language	Start Address	Practice Location

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