Organization Active NPI

Eric Egozi MD PL

  • Plastic and Reconstructive Surgery Physician
  • Clearwater, FL
National Provider Identifier
1477714293
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
ME93030 Issued in FL
Legal business name
ERIC EGOZI MD PL
Practice address
1608 Gulf to Bay Blvd
Clearwater, FL 33755
Phone
(727) 461-5872
Fax
(727) 449-2486
NPI assigned
Jun 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Authorized official

Name
Charlene S Smith
Title
Office MGR
Phone
(727) 461-5872

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X ME93030 FL
Surgery of the Hand (Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0105X ME93030 FL
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X ME93030 FL Primary

Addresses

Primary practice location

1608 Gulf to Bay Blvd
Clearwater, FL 33755

Mailing address

1608 Gulf to Bay Blvd.
Clearwater, FL 33755
Phone (727) 461-5872

Other identifiers 3

IdentifierTypeStateIssuer
DS6582OtherFLRAILRAOD MEDICARE
40356OtherFLBCBS
613486900OtherFLUS DOL

Other names 1

  • Egozi Plastic Surgery Other name

National Provider Directory

National Provider Directory

Locations

1608 Gulf To Bay Blvd
Clearwater, FL 33755
Phone (727) 461-5872

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1477714293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 GULF TO BAY BLVD.",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33755",
            "telephone_number": "727-461-5872",
            "fax_number": "727-449-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 GULF TO BAY BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33755",
            "telephone_number": "727-461-5872",
            "fax_number": "727-449-2486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC EGOZI MD PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "727-461-5872"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME93030",
            "primary": false
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgery of the Hand",
            "state": "FL",
            "license": "ME93030",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME93030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILRAOD MEDICARE",
            "identifier": "DS6582",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "40356",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DOL",
            "identifier": "613486900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Egozi Plastic Surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.