Provider Demographics
NPI:1659341683
Name:MAHARAJ, MADHURIE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MADHURIE
Middle Name:
Last Name:MAHARAJ
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 CANYON WAY
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3142
Mailing Address - Country:US
Mailing Address - Phone:561-333-2054
Mailing Address - Fax:
Practice Address - Street 1:1111 W BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-1638
Practice Address - Country:US
Practice Address - Phone:954-527-6061
Practice Address - Fax:954-467-9587
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 268881835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPU 4406OtherFL CONSULTANT LICENSE NUM
FLPS 26888OtherSTATE LICENSE NUMBER