| Dr Anthony S Capozzi Llc | |
|
1730 Dunlawton Ave Ste 3 Port Orange FL 32127-8986 | |
| (386) 957-3905 | |
| Not Available |
| Full Name | Dr Anthony S Capozzi Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1730 Dunlawton Ave Ste 3, Port Orange, Florida |
| Authorized Official Name and Position | Anthony Capozzi (OWNER) |
| Authorized Official Contact | 3869573905 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Anthony S Capozzi Llc 136 Julia St Unit 100 New Smyrna Beach FL 32168-7713 Ph: (386) 423-9161 | Dr Anthony S Capozzi Llc 1730 Dunlawton Ave Ste 3 Port Orange FL 32127-8986 Ph: (386) 957-3905 |
| NPI Number | 1063761427 |
|---|---|
| Provider Enumeration Date | 08/31/2012 |
| Last Update Date | 05/24/2022 |
| Certification Date | 05/24/2022 |
| Medicare PECOS PAC ID | 6709038615 |
|---|---|
| Medicare Enrollment ID | O20121128000366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063761427 | NPI | - | NPPES |
| EP827Z | Other | FL | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME105803 (Florida) | Primary |
| Provider Name | Anthony S Capozzi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528163367 PECOS PAC ID: 5294766887 Enrollment ID: I20110317000507 |
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