Provider Demographics
NPI:1619199684
Name:MAURER, SUSAN (CRNA, ARNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:MAURER
Suffix:
Gender:F
Credentials:CRNA, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6660 SW 117TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-2826
Mailing Address - Country:US
Mailing Address - Phone:305-630-3363
Mailing Address - Fax:305-630-3364
Practice Address - Street 1:6660 SW 117TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-2826
Practice Address - Country:US
Practice Address - Phone:305-630-3363
Practice Address - Fax:305-630-3364
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1309192367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered