Provider Demographics
NPI:1134964786
Name:MAZON, JAMIE CASTRO (ARNP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:CASTRO
Last Name:MAZON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:CASTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14196 77TH PL N
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-4421
Mailing Address - Country:US
Mailing Address - Phone:305-331-3349
Mailing Address - Fax:
Practice Address - Street 1:14196 77TH PL N
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-4421
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11033667207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine