Provider Demographics
NPI:1184647075
Name:BAT-AMI, MAYA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MAYA
Middle Name:
Last Name:BAT-AMI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7455 FAIRFAX DR BLDG F
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-4336
Mailing Address - Country:US
Mailing Address - Phone:954-454-5500
Mailing Address - Fax:954-926-0170
Practice Address - Street 1:2855 N UNIVERSITY DR STE 200
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-1403
Practice Address - Country:US
Practice Address - Phone:954-454-5500
Practice Address - Fax:954-926-0170
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 0004549103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73967Medicare UPIN