Healthcare Provider Details

I. General information

NPI: 1841101433
Provider Name (Legal Business Name): DAVID WAYNE BOZOSI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DAVEY WAYNE BOZOSI

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15255 MAX LEGGETT PKWY STE 4100
JACKSONVILLE FL
32218-7277
US

IV. Provider business mailing address

10899 CORAL SHORES DR UNIT 303
JACKSONVILLE FL
32256-2113
US

V. Phone/Fax

Practice location:
  • Phone: 904-427-1179
  • Fax:
Mailing address:
  • Phone: 727-729-2959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT27438
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: