Healthcare Provider Details

I. General information

NPI: 1447444021
Provider Name (Legal Business Name): BUZZELLA CHIROPRACTIC & REHABILITATION PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 S TAMIAMI TRL
OSPREY FL
34229-9206
US

IV. Provider business mailing address

428 S TAMIAMI TRL
OSPREY FL
34229-9206
US

V. Phone/Fax

Practice location:
  • Phone: 941-966-1414
  • Fax: 941-966-2424
Mailing address:
  • Phone: 941-966-1414
  • Fax: 941-966-2424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH8828
License Number StateFL

VIII. Authorized Official

Name: DR. ERNEST BUZZELLA JR.
Title or Position: CHIROPRACTOR/PRESIDENT
Credential: D.C.
Phone: 941-284-4222