Individual
NICHOLAS MAZZUCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RRA
Contact information
Practice address
3501 JOHNSON ST, HOLLYWOOD, FL 33021-5421
(954) 987-2000
Mailing address
5769 SW 42ND TER, MIAMI, FL 33155-5313
(786) 348-3595
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
RA165
FL
2471V0106X
Vascular-Interventional Technology Radiologic Technologist
CRT39545
FL
Other
Enumeration date
07/03/2024
Last updated
07/03/2024
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