Healthcare Provider Details

I. General information

NPI: 1376492082
Provider Name (Legal Business Name): BRIANI MAZUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 SW 74TH ST
MIAMI FL
33143-5165
US

IV. Provider business mailing address

7440 SW 130TH AVE
MIAMI FL
33183-3458
US

V. Phone/Fax

Practice location:
  • Phone: 305-735-3572
  • Fax:
Mailing address:
  • Phone: 786-879-1128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11049309
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number9609072
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: