Healthcare Provider Details

I. General information

NPI: 1326467416
Provider Name (Legal Business Name): TEOFIL BUZAS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2014
Last Update Date: 06/12/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6750 IMMOKALEE RD. BLDG 200, UNIT 206
NAPLES FL
34119
US

IV. Provider business mailing address

1773 STAR BATT DR
ROCHESTER HILLS MI
48309-3708
US

V. Phone/Fax

Practice location:
  • Phone: 941-529-1991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501016677
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number36814
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: