MEDICARE: SUSAN MAURER CRNA, ARNP

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	367500000X	Certified Registered Nurse Anesthetist	ARNP 1309192	FL

General Provider Information

NPI Number	:	1619199684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN MAURER CRNA, ARNP

Provider Business Mailing Address
First Line	:	6660 SW 117TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-2826
Country	:	US
Telephone Number	:	305-630-3363
Fax Number	:	305-630-3364

Provider Business Practice Location Address
First Line	:	6660 SW 117TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-2826
Country	:	US
Telephone Number	:	305-630-3363
Fax Number	:	305-630-3364

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/08/2007

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