| Doctor Name: | GEORGE N. MAIDA |
| NPI Number: | 1275547267 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | PY 2887 |
| Business Practice Address: | 645 Mayport Rd Suite 3b1 Atlantic Beach, FL - 322333491 |
| Business Phone Number: | 9042498304 |
| Business Fax Number: | 9042498134 |
| Mailing Address: | 645 Mayport Rd, Suite 3b1 ATLANTIC BEACH |
| State: | FL |
| Postal Code: | 322333491 |
| Phone Number: | 9042498304 |
| Fax Number: | 9042498134 |
| NPI Enumeration Date: | 07/28/2006 |
| NPI Last Update Date: | 07/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY 2887 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |