Provider Demographics
NPI:1235239351
Name:MAURER, PAUL W (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:W
Last Name:MAURER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3708 N ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4533
Mailing Address - Country:US
Mailing Address - Phone:305-296-1097
Mailing Address - Fax:305-296-8532
Practice Address - Street 1:3708 N ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4533
Practice Address - Country:US
Practice Address - Phone:305-296-1097
Practice Address - Fax:305-296-8532
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65103174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650945483OtherTAX IDENTIFICATION NUMBER
FL23694Medicare ID - Type UnspecifiedPROVIDER NUMBER