Individual ProviderEric MalzNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address525 Technology Park Ste 109, Lake Mary, FL 32746-7107(407) 647-2346PECOS EnrollmentBased on the most recent information from CMS, provider Eric Malz is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:21 AM.Profile DetailsProvider ID1598795536Provider TypeIndividualFull NameMalz, EricTitleMr.CredentialAPNGenderMaleSole ProprietorYesEnumeration Date7/4/2006Last Updated10/25/2024Contact InformationPractice LocationPractice Address525 Technology Park Ste 109, Lake Mary, FL 32746-7107Phone(407) 647-2346Fax(407) 647-5431Mailing LocationMailing Address525 Technology Park Ste 109, Lake Mary, FL 32746-7107Phone(407) 647-2346Fax(407) 647-5431Provider TaxonomiesCodeDescriptionLicenseCode363LP0808XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN11024056FloridaCode363LP0808XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense400555New YorkCode363LP0808XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense26NC11014300New Jersey