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Organization
RICHARD K MAZA MD LLC
Active
Organization
RICHARD K MAZA MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD KAZDIN MAZA MD (OWNER)
(727) 725-6170
Entity
Organization
Contact information
Practice address
3253 N MCMULLEN BOOTH RD, SUITE 200, CLEARWATER, FL 33761-2043
(727) 725-6170
(727) 799-3511
Mailing address
PO BOX 1491, DUNEDIN, FL 34697-1491
(727) 725-6170
(727) 799-3511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME37253
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62280
BLUE SHIELD
FL
Enumeration date
02/15/2007
Last updated
03/06/2014
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