Carmen I Tozzo PA
Organization Active NPI Clinical Psychologist · Williston, FL
NPI 1659620409 · NPPES record last updated Oct 28, 2015
Key facts
- NPI
- 1659620409
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PY5911 (FL)
- Legal business name
- CARMEN I TOZZO PA
- Practice address
- 630 N Main St
Williston, FL 32696-1705 - Phone
- (352) 529-2570
- Fax
- (352) 529-2570
- NPI assigned
- Sep 6, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Carmen I Tozzo, PH,D.
- Title
- President
- Phone
- (352) 318-2339
Practitioners 1
-
Carmen A. Tozzo, PHD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120927000581 | FL | Part B Supplier - Clinic/Group Practice | 1850540311 |
Receives reassigned benefits from 1 practitioner Practice locations: Williston, FL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | PY5911 | FL | Yes |
Addresses
Primary practice location
630 N Main St
Williston, FL 32696-1705
Mailing address
PO Box 817
Williston, FL 32696-0817
Phone (352) 318-2339
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009252000 | Medicaid | FL |
Other providers in Williston, FL
- Attul Mulji Bharadwa
- Payal Bhatt Abraham
- Amber Bowers
- Andrew Nelson Brice
- Anita Brown
- CDPG, P.L.
- Choicesfla Counseling Services LLC
- Gina Renee Chubb
- CNS Holding Company LLC
- Compassionate Care Group Home LLC
All providers in Williston, FL · Clinical Psychologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.