Individual
MRS. MARY RACHEL HAZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 846-0372
(352) 846-0387
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 846-0372
(352) 846-0387
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9101614
FL
363AS0400X
Surgical Physician Assistant
PA9101614
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292831100
—
FL
Enumeration date
05/24/2006
Last updated
06/02/2009
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