| Richard K Maza Md Llc | |
|
3253 N Mcmullen Booth Rd Suite 200 Clearwater FL 33761-2043 | |
| (727) 725-6170 | |
| (727) 799-3511 |
| Full Name | Richard K Maza Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3253 N Mcmullen Booth Rd, Clearwater, Florida |
| Authorized Official Name and Position | Richard Kazdin Maza (OWNER) |
| Authorized Official Contact | 7277256170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard K Maza Md Llc Po Box 1491 Dunedin FL 34697-1491 Ph: (727) 725-6170 | Richard K Maza Md Llc 3253 N Mcmullen Booth Rd Suite 200 Clearwater FL 33761-2043 Ph: (727) 725-6170 |
| NPI Number | 1972646263 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 03/06/2014 |
| Medicare PECOS PAC ID | 0840392957 |
|---|---|
| Medicare Enrollment ID | O20070220000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972646263 | NPI | - | NPPES |
| 62280 | Other | FL | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME37253 (Florida) | Primary |
| Provider Name | Richard K Maza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861490872 PECOS PAC ID: 6002918216 Enrollment ID: I20070219000341 |
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