Individual provider Active NPI

Mackenzie Leigh Mauldin, APRN

  • Nurse Practitioner
  • Leesburg, FL
National Provider Identifier
1710855044
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11038423 Issued in FL
Practice address
25010 US Highway 27 Ste a
Leesburg, FL 34748-8400
Phone
(352) 254-1165
NPI assigned
Oct 28, 2025
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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 11038423 FL Primary

Addresses

Primary practice location

25010 US Highway 27 Ste a
Leesburg, FL 34748-8400

Mailing address

25010 US Highway 27 Ste a
Leesburg, FL 34748-8400
Phone (352) 254-1165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11038423FLMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1761609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1710855044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25010 US HIGHWAY 27 STE A",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347488400",
            "telephone_number": "352-254-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25010 US HIGHWAY 27 STE A",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347488400",
            "telephone_number": "352-254-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAULDIN",
        "first_name": "MACKENZIE",
        "middle_name": "LEIGH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-28",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11038423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.