Provider Demographics
NPI:1265752562
Name:MAZLIN, MYRA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MYRA
Middle Name:
Last Name:MAZLIN
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6524 INDIAN TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-3404
Mailing Address - Country:US
Mailing Address - Phone:561-866-7026
Mailing Address - Fax:
Practice Address - Street 1:6524 INDIAN TRAIL DR
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-3404
Practice Address - Country:US
Practice Address - Phone:561-866-7026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1182592363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily