MEDICARE: MAYA AYOUB D.D.S

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	1223G0001X	General Practice Dentistry	DN21235	FL

General Provider Information

NPI Number	:	1871938423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYA AYOUB D.D.S

Provider Business Mailing Address
First Line	:	2233 E KALEY AVE APT 6
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-3234
Country	:	US
Telephone Number	:	347-401-0481
Fax Number	:

Provider Business Practice Location Address
First Line	:	2233 E KALEY AVE APT 6
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-3234
Country	:	US
Telephone Number	:	347-401-0481
Fax Number	:

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

Provider Enumeration Date	:	05/08/2013
Last Update Date	:	04/25/2018

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