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General NPI Number Information
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NPI Number | 1952856494
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Entity Type | Individual
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Provider Name | DANIELLE T MAZILE NP
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Gender | Female
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Dates
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Enumeration Date | 08/24/2016
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 4295 HEMPSTEAD TPKE
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City | BETHPAGE
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State | NY
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Zip | 11714-5713
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Country | US
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Telephone | 904-372-3943
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Fax | 904-212-1618
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Provider Business Mailing Address
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Address Line | 7751 BELFORT PKWY STE 120
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6921
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Country | US
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Telephone | 904-372-3943
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Fax | 904-212-1618
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F356637-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 356637
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License Number State | NY
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