MEDICARE: SUSAN J MAURER PA

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	363AM0700X	Medical Physician Assistant	PA 9101946	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	:	1700873890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN J MAURER PA

Provider Business Mailing Address
First Line	:	1501 GOVERNMENT RD
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-5108
Country	:	US
Telephone Number	:	305-295-7550
Fax Number	:	305-296-3010

Provider Business Practice Location Address
First Line	:	15O1 GOVERNMENT RD
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-5108
Country	:	US
Telephone Number	:	305-295-7550
Fax Number	:	305-296-3010

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	07/07/2011

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