MEDICARE: RAOUL D MAIZEL MD

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	207W00000X	Ophthalmology Physician	ME0060040	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180015819	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1831192954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAOUL D MAIZEL MD

Provider Business Mailing Address
First Line	:	17560 HIGHWAY 441
Second Line	:
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-6711
Country	:	US
Telephone Number	:	352-735-2020
Fax Number	:	352-735-2322

Provider Business Practice Location Address
First Line	:	17560 HIGHWAY 441
Second Line	:
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-6711
Country	:	US
Telephone Number	:	352-735-2020
Fax Number	:	352-735-2322

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	09/30/2009

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Directions to “ RAOUL D MAIZEL MD” Practice Location

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