Healthcare Provider Details

I. General information

NPI: 1346738937
Provider Name (Legal Business Name): THOMAS C GLIOZZO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2018
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RIVERVIEW PLZ
RED BANK NJ
07701-1864
US

IV. Provider business mailing address

1775 W HIBISCUS BLVD
MELBOURNE FL
32901-2620
US

V. Phone/Fax

Practice location:
  • Phone: 732-714-2700
  • Fax: 732-358-0605
Mailing address:
  • Phone: 321-837-3820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME155733
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA12355700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: