Healthcare Provider Details

I. General information

NPI: 1356030498
Provider Name (Legal Business Name): ANTHONY TRUNZO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 13TH ST
GULFPORT MS
39501-2515
US

IV. Provider business mailing address

4500 13TH ST
GULFPORT MS
39501-2515
US

V. Phone/Fax

Practice location:
  • Phone: 228-867-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number37245
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: