Provider Demographics
NPI:1588801856
Name:MAGNOZZI, CARLA ANN (BS,MA)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:ANN
Last Name:MAGNOZZI
Suffix:
Gender:F
Credentials:BS,MA
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:ANN
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS,MA
Mailing Address - Street 1:7380 SIKA DEER WAY
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-5711
Mailing Address - Country:US
Mailing Address - Phone:239-560-9064
Mailing Address - Fax:
Practice Address - Street 1:7380 SIKA DEER WAY
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-5711
Practice Address - Country:US
Practice Address - Phone:239-560-9064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL252Y00000X252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency