=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437417599
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES AZZI M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2012
-----------------------------------------------------
Last Update Date | 08/01/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2151 S ALT A1A STE 425
-----------------------------------------------------
City | JUPITER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33477-4070
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-979-2001
-----------------------------------------------------
Fax | 561-462-0852
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2151 S ALT A1A STE 425
-----------------------------------------------------
City | JUPITER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33477-4070
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-979-2001
-----------------------------------------------------
Fax | 561-462-0852
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207YX0007X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
-----------------------------------------------------
License Number | ME134770
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------