Provider Demographics
NPI:1528063179
Name:AIKEN, MAURICE WARREN (DPM)
Entity type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:WARREN
Last Name:AIKEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 MAIN ST STE L
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-5225
Mailing Address - Country:US
Mailing Address - Phone:727-734-5575
Mailing Address - Fax:727-733-4147
Practice Address - Street 1:1022 MAIN ST STE L
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-5225
Practice Address - Country:US
Practice Address - Phone:727-734-5575
Practice Address - Fax:727-733-4147
Is Sole Proprietor?:No
Enumeration Date:2005-06-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3681213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1306219597OtherORGANIZATIONAL NPI
MD580MOtherPTAN
FLPO 3681OtherSTATE MEDICAL LICENSE
10416267OtherCAQH
10416267OtherCAQH
FLIM367ZMedicare PIN