Healthcare Provider Details

I. General information

NPI: 1548766769
Provider Name (Legal Business Name): BARBARA BUZZO ARNP FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4450 W EAU GALLIE BLVD STE 250
MELBOURNE FL
32934-7215
US

IV. Provider business mailing address

2760 PINE LILY LN
COCOA FL
32926-3620
US

V. Phone/Fax

Practice location:
  • Phone: 321-751-6671
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9283216
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: