Provider Demographics
NPI:1043589922
Name:MAZELOW, JOCELYN MARIE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:JOCELYN
Middle Name:MARIE
Last Name:MAZELOW
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E. GRANADA BLVD
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32176
Mailing Address - Country:US
Mailing Address - Phone:386-677-8849
Mailing Address - Fax:386-673-7661
Practice Address - Street 1:205 E GRANADA BLVD.
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32176
Practice Address - Country:US
Practice Address - Phone:386-677-8849
Practice Address - Fax:386-673-7661
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0037947183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist