Individual
MIGUEL ANGEL MAZARIEGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1150 BELL SHOALS RD, BRANDON, FL 33511-9001
(813) 681-6064
(813) 653-4132
Mailing address
1150 BELL SHOALS RD, BRANDON, FL 33511-9001
(813) 681-6064
(813) 653-4132
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME0069553
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
378959400
—
FL
Enumeration date
09/02/2005
Last updated
04/28/2021
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