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Contact Information

MARY R HAZAN, PA
108 NW 76TH DRIVE
SUITE A
GAINESVILLE, FL32607
 Phone: 352-332-7873
 Fax:
 Website: http://www.pureaestheticsgainesville.com
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MARY R HAZAN · (Female)

NPI # 1376598565
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 05/24/2006
Last updated 06/02/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • FL License # PA9101614
  • FL Medicaid 292831100
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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