Healthcare Provider Details

I. General information

NPI: 1134441934
Provider Name (Legal Business Name): DR. MARC J BROZOVICH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2010
Last Update Date: 02/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32765 EILAND BLVD
ZEPHYRHILLS FL
33545-5268
US

IV. Provider business mailing address

32765 EILAND BLVD
ZEPHYRHILLS FL
33545-5268
US

V. Phone/Fax

Practice location:
  • Phone: 813-779-2510
  • Fax:
Mailing address:
  • Phone: 813-779-2510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS35785
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: