Healthcare Provider Details

I. General information

NPI: 1346682606
Provider Name (Legal Business Name): KEVIN D CUZZO MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2013
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2817 ROCK MERRITT AVE
FORT BRAGG NC
28310-3097
US

IV. Provider business mailing address

2400 S RIDGEWOOD AVE
SOUTH DAYTONA FL
32119-3097
US

V. Phone/Fax

Practice location:
  • Phone: 910-907-9089
  • Fax:
Mailing address:
  • Phone: 631-678-2632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: