Healthcare Provider Details

I. General information

NPI: 1619499787
Provider Name (Legal Business Name): ANTHONY PAUL INZILLO PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2017
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 SCENIC HWY STE A
PENSACOLA FL
32503-6866
US

IV. Provider business mailing address

5455 PRIMROSE DR
PENSACOLA FL
32504-8445
US

V. Phone/Fax

Practice location:
  • Phone: 850-696-6887
  • Fax: 850-203-2589
Mailing address:
  • Phone: 850-696-6878
  • Fax: 850-203-2589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number27153
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: