Provider Demographics
NPI:1164460770
Name:CAMUZZI, MARCO A (DO)
Entity Type:Individual
Prefix:DR
First Name:MARCO
Middle Name:A
Last Name:CAMUZZI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2865 CHANCERY LN
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1427
Mailing Address - Country:US
Mailing Address - Phone:727-631-3756
Mailing Address - Fax:
Practice Address - Street 1:2865 CHANCERY LN
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1427
Practice Address - Country:US
Practice Address - Phone:727-631-3756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9399208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL298238OtherAVMED
FLI32126Medicare UPIN
FL001399700Medicaid
FL01617OtherBCBS
FLP00753966OtherRAILROAD MEDICARE
FL3918570OtherCIGNA
FL01617YMedicare PIN
FL7040670OtherAETNA
FL1055320OtherCAREPLUS
FL2541165OtherUNITED