Provider Demographics
NPI:1043551252
Name:MAZAL NURSING SERVICES, INC
Entity type:Organization
Organization Name:MAZAL NURSING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-554-7010
Mailing Address - Street 1:2828 SW 22ND ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3214
Mailing Address - Country:US
Mailing Address - Phone:305-945-4488
Mailing Address - Fax:305-945-4888
Practice Address - Street 1:2828 SW 22ND ST STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3214
Practice Address - Country:US
Practice Address - Phone:786-263-2933
Practice Address - Fax:305-945-4888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211620251J00000X
251J00000X, 3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018518500Medicaid
FL107976601Medicaid