Provider Demographics
NPI:1336573385
Name:SZOZDA, JO ANN (DO)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:ANN
Last Name:SZOZDA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7272 W ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-4238
Mailing Address - Country:US
Mailing Address - Phone:954-532-4275
Mailing Address - Fax:
Practice Address - Street 1:7272 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-4238
Practice Address - Country:US
Practice Address - Phone:954-532-4275
Practice Address - Fax:954-532-7925
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3231156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician