Individual
SAMUEL ANDREW MIZENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, LAT, ATC, CSCS
Contact information
Practice address
1001 AVALON PARK BLVD S, ORLANDO, FL 32828-7764
(724) 831-8521
Mailing address
1001 AVALON PARK BLVD S, ORLANDO, FL 32828-7764
(724) 831-8521
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL2235
FL
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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