MEDICARE: PAUL W MAURER

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	291U00000X	Clinical Medical Laboratory	ME0065103	FL

General Provider Information

NPI Number	:	1891969457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL W MAURER

Provider Business Mailing Address
First Line	:	3708 N ROOSEVELT BLVD
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-4533
Country	:	US
Telephone Number	:	305-296-1097
Fax Number	:	305-926-8532

Provider Business Practice Location Address
First Line	:	3708 N ROOSEVELT BLVD
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-4533
Country	:	US
Telephone Number	:	305-296-1097
Fax Number	:	305-926-8532

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. PAUL W MAURER
Credential	:	M.D.
Telephone Number	:	305-296-1097

Provider Enumeration Date	:	04/15/2008
Last Update Date	:	09/24/2009

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