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NPI Code Detail

MEDICARE: SULA MAZIMBA M.D.

MEDICARE: SULA MAZIMBA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RA0001XAdvanced Heart Failure and Transplant Cardiology Physician0101256847VA
2207R00000XInternal Medicine Physician35085788MOH
3207RC0000XCardiovascular Disease Physician0101256847VA
4207RA0001XAdvanced Heart Failure and Transplant Cardiology PhysicianME161996FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023000809
Entity Type Code : Individual
Provider Name (Legal Business Name) : SULA MAZIMBA M.D.
Provider Business Mailing Address
First Line : 2415 N ORANGE AVE STE 700
Second Line :
City : ORLANDO
State : FL
Zip : 32804-5521
Country : US
Telephone Number : 407-303-2474
Fax Number :
Provider Business Practice Location Address
First Line : 2415 N ORANGE AVE STE 700
Second Line :
City : ORLANDO
State : FL
Zip : 32804-5521
Country : US
Telephone Number : 407-303-2474
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2005
Last Update Date : 06/29/2023

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Directions to “ SULA MAZIMBA M.D.” Practice Location

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