NPIMap

Organization Active NPI

Michael D Mozzetti MD PL

  • Family Medicine Physician
  • Port Charlotte, FL
National Provider Identifier
1003073214
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME069032
Legal business name
MICHAEL D MOZZETTI MD PL
Practice address
3161 Harbor Blvd
Suite a
Port Charlotte, FL 33952-6754
Phone
(941) 629-1218
Fax
(941) 625-9465
NPI assigned
May 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael Dominic Mozzetti Sr., MD, PL
Title
Owner
Phone
(941) 629-1218

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME069032 Primary

Addresses

Primary practice location

3161 Harbor Blvd
Suite a
Port Charlotte, FL 33952-6754

Mailing address

3161 Harbor Blvd
Suite a
Port Charlotte, FL 33952-6754
Phone (941) 629-1218

Other identifiers 5

IdentifierTypeStateIssuer
32306OtherFLBLUE CROSS BLUE SHIELD
1867775OtherFLAETNA
262587296OtherFLHUMANA
262587296OtherFLBCBS FLORIDA
262587296OtherFLCIGNA

Other names 1

  • Express Care Medical Cinic Doing business as

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1003073214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3161 HARBOR BLVD",
            "address_2": "SUITE A",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526754",
            "telephone_number": "941-629-1218",
            "fax_number": "941-625-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3161 HARBOR BLVD",
            "address_2": "SUITE A",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526754",
            "telephone_number": "941-629-1218",
            "fax_number": "941-625-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D MOZZETTI MD PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "MOZZETTI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DOMINIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-629-1218",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD, PL"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": "ME069032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "32306",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1867775",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "262587296",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FLORIDA",
            "identifier": "262587296",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "262587296",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Express Care Medical Cinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.