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General NPI Number Information
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NPI Number | 1033467964
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Entity Type | Individual
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Provider Name | PASQUALE ANGELO CAPOZZOLI PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 08/27/2012
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 5290 SUMMERLIN COMMONS WAY STE 1002
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City | FORT MYERS
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State | FL
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Zip | 33907-2162
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Country | US
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Telephone | 239-274-7792
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Fax | 239-247-5344
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Provider Business Mailing Address
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Address Line | 5290 SUMMERLIN COMMONS WAY STE 1002
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City | FORT MYERS
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State | FL
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Zip | 33907-2162
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Country | US
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Telephone | 239-274-7792
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Fax | 239-247-5344
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY8575
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License Number State | FL
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