Provider Demographics
NPI:1427032184
Name:MAZUR, JANICE E (ARNP)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:E
Last Name:MAZUR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:E
Other - Last Name:MASCITTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1250 PINE RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108
Mailing Address - Country:US
Mailing Address - Phone:239-566-7676
Mailing Address - Fax:239-254-3105
Practice Address - Street 1:1250 PINE RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108
Practice Address - Country:US
Practice Address - Phone:239-566-7676
Practice Address - Fax:239-254-3105
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2012-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3319172364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS47726Medicare UPIN