Individual
JACK J WAZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 FLOYD ST, SARASOTA, FL 34239-2932
(941) 366-9222
(941) 365-2269
Mailing address
PO BOX 863407, ORLANDO, FL 32886-3407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
Primary
ME41616
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274489900
—
FL
01
—
31040
BCBS
FL
Enumeration date
08/09/2006
Last updated
12/02/2020
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