=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922409770
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MZ MEDICAL SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2014
-----------------------------------------------------
Last Update Date | 09/11/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 330 SW 27TH AVE STE 605
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33135-2968
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-534-5227
-----------------------------------------------------
Fax | 786-534-9165
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 330 SW 27TH AVE STE 605
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33135-2968
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-534-5227
-----------------------------------------------------
Fax | 786-534-9165
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. MAYRA L ZENO
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 786-534-5227
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM1300X
-----------------------------------------------------
Taxonomy Name | Multi-Specialty Clinic/Center
-----------------------------------------------------
License Number | ME62905
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------