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General NPI Number Information
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NPI Number | 1932323839
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Entity Type | Organization
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Legal Business Name | KOZAK P T & ASSOC INC
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 05/23/2013
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Provider Practice Location Address
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Address Line | 10099 SEMINOLE BLVD SUITE 5A
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City | SEMINOLE
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State | FL
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Zip | 33772-2521
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Country | US
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Telephone | 727-399-8226
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Fax | 727-393-4823
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Provider Business Mailing Address
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Address Line | 10099 SEMINOLE BLVD SUITE 5A
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City | SEMINOLE
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State | FL
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Zip | 33772-2521
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Country | US
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Telephone | 727-399-8226
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Fax | 727-393-4823
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JOHN ANDREW KOZAK
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Credential | P.T.
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Telephone | 727-399-8226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT 3271
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License Number State | FL
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