MEDICARE: TACITA PERSAD-MAHARAJ AUD.

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	231H00000X	Audiologist	AY1706	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669755849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TACITA PERSAD-MAHARAJ AUD.

Provider Business Mailing Address
First Line	:	2950 CLEVELAND CLINIC BLVD
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331-3625
Country	:	US
Telephone Number	:	954-659-5786
Fax Number	:

Provider Business Practice Location Address
First Line	:	2950 CLEVELAND CLINIC BLVD
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331-3420
Country	:	US
Telephone Number	:	954-659-5786
Fax Number	:

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

Provider Enumeration Date	:	09/23/2011
Last Update Date	:	02/11/2026

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