| Entity Name: | DAVID MAZER, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 Jan 2000 (25 years ago) |
| Document Number: | P00000003735 |
| FEI/EIN Number | 593617330 |
| Address: | 3295 Lakeview Oaks Dr, LONGWOOD, FL, 32779, US |
| Mail Address: | 3295 Lakeview Oaks Dr, LONGWOOD, FL, 32779, US |
| ZIP code: | 32779 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043296189 | 2005-12-20 | 2014-08-19 | PO BOX 950699, LAKE MARY, FL, 327950699, US | 1414 KUHL AVE, ORLANDO, FL, 328062008, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 407-805-9503 |
| Fax | 3213967711 |
Authorized person
| Name | DR. DAVID K MAZER |
| Role | PROVIDER/OWNER |
| Phone | 4078059503 |
Taxonomy
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 266648100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MAZER DAVID KDr. | Agent | 3295 Lakeview Oaks Dr, LONGWOOD, FL, 32779 |
| Name | Role | Address |
|---|---|---|
| MAZER DAVID K | Director | 3295 Lakeview Oaks Dr, LONGWOOD, FL, 32779 |
| Name | Role | Address |
|---|---|---|
| MAZER DAVID K | President | 3295 Lakeview Oaks Dr, LONGWOOD, FL, 32779 |
| Name | Role | Address |
|---|---|---|
| MAZER CHERIE RDr. | Secretary | 3295 Lakeview Oaks Dr, LONGWOOD, FL, 32779 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2020-01-17 | MAZER, DAVID K, Dr. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-03-20 | 3295 Lakeview Oaks Dr, LONGWOOD, FL 32779 | No data |
| CHANGE OF MAILING ADDRESS | 2016-03-20 | 3295 Lakeview Oaks Dr, LONGWOOD, FL 32779 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-03-20 | 3295 Lakeview Oaks Dr, LONGWOOD, FL 32779 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-30 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-01-26 |
| ANNUAL REPORT | 2016-03-20 |
| ANNUAL REPORT | 2015-01-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
