1063483238 NPI number — NUNZIO P SOSSI M.D..PHD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063483238 NPI number — NUNZIO P SOSSI M.D..PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOSSI
Provider First Name:
NUNZIO
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D..PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063483238
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
550 HERITAGE DR STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JUPITER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33458-3030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-444-0094
Provider Business Mailing Address Fax Number:
561-318-7970

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
550 HERITAGE DR STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JUPITER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33458-3030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-444-0094
Provider Business Practice Location Address Fax Number:
561-318-7970
Provider Enumeration Date:
01/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  ME60169 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 054505800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0801307 . This is a "EVERCARE/UNITEDHEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 51198 . This is a "COVENTRY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 910142 . This is a "BEECH STREET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 12288 . This is a "BCBS OF FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5322 . This is a "DIMENSION HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0004201207 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1329328 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 180017193 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 321739 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com