Provider Demographics
NPI:1861644353
Name:ANTHONY N PANNOZZO MD PA
Entity Type:Organization
Organization Name:ANTHONY N PANNOZZO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:PANNOZZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-381-5800
Mailing Address - Street 1:16244 MILITARY TRL
Mailing Address - Street 2:#740
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6534
Mailing Address - Country:US
Mailing Address - Phone:561-381-5800
Mailing Address - Fax:561-381-5003
Practice Address - Street 1:16244 MILITARY TRL
Practice Address - Street 2:#740
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6534
Practice Address - Country:US
Practice Address - Phone:561-381-5800
Practice Address - Fax:561-381-5003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87910208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty