Provider Demographics
NPI:1003086489
Name:BOZONE, DARYL D (LCSW)
Entity type:Individual
Prefix:MR
First Name:DARYL
Middle Name:D
Last Name:BOZONE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13220 SCHARBER RD
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33525-8008
Mailing Address - Country:US
Mailing Address - Phone:352-588-5135
Mailing Address - Fax:352-588-5135
Practice Address - Street 1:13220 SCHARBER RD
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525-8008
Practice Address - Country:US
Practice Address - Phone:352-588-5135
Practice Address - Fax:352-588-5135
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW88511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical