Individual
LENORA MAZON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MMA
Contact information
Practice address
307A S MAIN ST, HAVANA, FL 32333-2007
(850) 616-5005
Mailing address
211 E 10TH AVE, HAVANA, FL 32333-1915
(850) 616-5005
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
FL
251C00000X
Developmentally Disabled Services Day Training Agency
—
FL
253Z00000X
In Home Supportive Care Agency
—
FL
347C00000X
Private Vehicle
—
FL
372600000X
Adult Companion
—
FL
374U00000X
Home Health Aide
Primary
—
FL
376J00000X
Homemaker
—
FL
385H00000X
Respite Care
—
FL
385HR2065X
Child Physical Disabilities Respite Care
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0401
—
FL
Enumeration date
04/10/2019
Last updated
06/11/2019
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