MEDICARE: SUZANNE MAYE APRN

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	363L00000X	Nurse Practitioner	67626	NM
2	363LF0000X	Family Nurse Practitioner	95021845	CA
3	363L00000X	Nurse Practitioner	APRN11009198	FL

General Provider Information

NPI Number	:	1780263665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE MAYE APRN

Provider Business Mailing Address
First Line	:	3700 WINDMEADOWS BLVD APT E60
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-0426
Country	:	US
Telephone Number	:	352-989-0159
Fax Number	:

Provider Business Practice Location Address
First Line	:	2498 STEVENS CREEK BLVD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-1652
Country	:	US
Telephone Number	:	408-998-5400
Fax Number	:	408-998-5414

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

Provider Enumeration Date	:	04/07/2021
Last Update Date	:	12/09/2022

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Directions to “ SUZANNE MAYE APRN” Practice Location

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