Healthcare Provider Details

I. General information

NPI: 1578572046
Provider Name (Legal Business Name): ALEXANDER MAZUROVSKY D.C., APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 CORAL RIDGE DR
CORAL SPRINGS FL
33071-4180
US

IV. Provider business mailing address

9217 OLMSTEAD DR
LAKE WORTH FL
33467-3603
US

V. Phone/Fax

Practice location:
  • Phone: 917-648-1005
  • Fax:
Mailing address:
  • Phone: 917-648-1005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11046222
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX009550
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: