Provider Demographics
NPI:1851394274
Name:HAZELWOOD, SYLVIA LEAN (ARNP-C)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:LEAN
Last Name:HAZELWOOD
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6210 UPCOUNTRY DRIVE
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-2860
Mailing Address - Country:US
Mailing Address - Phone:813-486-4612
Mailing Address - Fax:813-200-8913
Practice Address - Street 1:6210 UPCOUNTRY DRIVE
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-2860
Practice Address - Country:US
Practice Address - Phone:813-486-4612
Practice Address - Fax:813-200-8913
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3233312363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5000014804OtherRAILROAD
FL303319800Medicaid
FLY0755OtherBLUE CROSS BLUE SHIELD
FLS55016Medicare UPIN
FLE0668VMedicare ID - Type Unspecified