Provider Demographics
NPI:1619942687
Name:PILOZZI, ANTONIO (PT)
Entity Type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:
Last Name:PILOZZI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12300 SOUTHSHORE BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6237
Mailing Address - Country:US
Mailing Address - Phone:561-318-7779
Mailing Address - Fax:561-318-7344
Practice Address - Street 1:12300 SOUTHSHORE BLVD STE 102
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6237
Practice Address - Country:US
Practice Address - Phone:561-318-7779
Practice Address - Fax:561-318-7344
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14215225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY912HOtherBCBS GROUP NUMBER
FLDB1527OtherRAILROAD MEDICARE
FLP00089773OtherRAILROAD MEDICARE INDIVID
FLY036POtherBCBS INDIVIDUAL NUMBER
FLU1028ZMedicare PIN
FLY912HOtherBCBS GROUP NUMBER