Provider Demographics
NPI:1003585324
Name:ROWE, MAYA (PA-C)
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:ROWE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MAYA
Other - Middle Name:
Other - Last Name:SINANOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:699 W COCOA BEACH CSWY STE 505
Mailing Address - Street 2:
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-3562
Mailing Address - Country:US
Mailing Address - Phone:321-868-4100
Mailing Address - Fax:
Practice Address - Street 1:699 W COCOA BEACH CSWY STE 505
Practice Address - Street 2:
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-3562
Practice Address - Country:US
Practice Address - Phone:321-868-4100
Practice Address - Fax:321-868-8374
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9114920363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116782700Medicaid
FLQD212OtherHF MA