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NPI Code Detail

MEDICARE: DR. JOSE GUILLERMO MAZA MD

MEDICARE: DR. JOSE GUILLERMO MAZA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice PhysicianACN545FL
2208D00000XGeneral Practice Physician18555PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467885640
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSE GUILLERMO MAZA MD
Provider Business Mailing Address
First Line : 118 W ORANGE ST
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32714-2537
Country : US
Telephone Number : 321-422-0574
Fax Number : 321-422-0765
Provider Business Practice Location Address
First Line : 118 W ORANGE ST
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32714-2537
Country : US
Telephone Number : 321-422-0574
Fax Number : 321-422-0765
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2013
Last Update Date : 10/09/2025

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Directions to “ DR. JOSE GUILLERMO MAZA MD” Practice Location

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