Individual provider Active NPI

Joyce J Mraz, ARNP,RN

  • Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1194702399
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP1204432 Issued in FL
Practice address
3564 Avalon Park East Blvd Ste 133
Orlando, FL 32828-7365
Phone
(407) 657-9368
Fax
(407) 823-3082
NPI assigned
Dec 28, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP1204432 FL Primary

Addresses

Primary practice location

3564 Avalon Park East Blvd Ste 133
Orlando, FL 32828-7365

Mailing address

3564 Avalon Park East Blvd Ste 133
Orlando, FL 32828-7365
Phone (407) 657-9368

Other identifiers 1

IdentifierTypeStateIssuer
306794700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040407001170 FL Practitioner - Nurse Practitioner 1052304664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Gary G Lehman MD PA PastSince Oct 24, 1999 Accepting new patients
Mark a. Bobek M.D., PA Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258502400000",
    "number": "1194702399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3564 AVALON PARK EAST BLVD STE 133",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287365",
            "telephone_number": "407-657-9368",
            "fax_number": "407-823-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3564 AVALON PARK EAST BLVD STE 133",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287365",
            "telephone_number": "407-657-9368",
            "fax_number": "407-823-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MRAZ",
        "first_name": "JOYCE",
        "middle_name": "J",
        "credential": "ARNP,RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2009-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP1204432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306794700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.