Mark A Bozzo, MASSAGE THERAPIST

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA0022905 Issued in FL

Practice address

7791 South US Highway 1
Port Saint Lucie, FL 34952

Phone

(772) 342-2805

NPI assigned

May 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407060965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 SW PISANO ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349533600",
            "telephone_number": "772-342-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7791 SOUTH US HIGHWAY 1",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "34952",
            "telephone_number": "772-342-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZZO",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA0022905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.