Healthcare Provider Details

I. General information

NPI: 1427619170
Provider Name (Legal Business Name): KRISTEN MAZUR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTEN ARMSTRONG PA-C

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 N STONE ST STE A
DELAND FL
32720-0824
US

IV. Provider business mailing address

1070 N STONE ST STE A
DELAND FL
32720-0824
US

V. Phone/Fax

Practice location:
  • Phone: 386-943-7100
  • Fax:
Mailing address:
  • Phone: 386-943-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601012134
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9120531
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: