Provider Demographics
NPI:1619364619
Name:MAZZAFERRO, MARY
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:MAZZAFERRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 COCONUT CREEK PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33066-1639
Mailing Address - Country:US
Mailing Address - Phone:954-977-9767
Mailing Address - Fax:954-977-9768
Practice Address - Street 1:3730 COCONUT CREEK PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33066-1639
Practice Address - Country:US
Practice Address - Phone:954-977-9767
Practice Address - Fax:954-977-9768
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care