Teresa M Mazur
Emergency Physician
400 Health Park Blvd
St Augustine
, Florida 32086-5784
Teresa M Mazur
Emergency Physician
400 Health Park Blvd
St Augustine
, Florida 32086-5784
(505) 923-6770
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About
Features
Specialties
- Emergency Physician
Languages spoken
- English
Location
First Address
- Teresa M Mazur
- Po Box 26666 Provider Enrollment
- Albuquerque, NM
- Zip : 87125-6666
- Phone : (505) 923-6770
Second Address
- Teresa M Mazur
- 400 Health Park Blvd
- St Augustine, FL
- Zip : 32086-5784
- Fax : (904) 346-0113
- Phone : (904) 826-4700
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207P00000X | Emergency Physician | ME0066495 | FL |
National Provider Identifier
| NPI | 1013002864 |
|---|---|
| Provider Name | Teresa M Mazur |
| First Address | Albuquerque, NM 87125-6666 |
| Second Address | St Augustine, FL 32086-5784 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/10/2006 |
| Last Update Date | 17/10/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 26101 | BCBS (01) | FL |
| 376205000 | (05) | FL |
| F90025 | (02) | FL |
| P00331048 | RAILROAD MEDICARE - FLAGL (01) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.