Provider Demographics
NPI:1720226475
Name:TOZZI, EDILENE TIZZO (PT)
Entity Type:Individual
Prefix:
First Name:EDILENE
Middle Name:TIZZO
Last Name:TOZZI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 SAPPHIRE LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3174
Mailing Address - Country:US
Mailing Address - Phone:954-389-3040
Mailing Address - Fax:
Practice Address - Street 1:14505 COMMERCE WAY STE 450
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1588
Practice Address - Country:US
Practice Address - Phone:305-512-1550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT226922251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010060900Medicaid