Individual provider · NPI-1

Marcello A Borzatta, MD

· Crestview, FL

NPI number1154368181
StatusActive
Last updated in NPPESMay 24, 2024

Details

NPI
1154368181
Entity type
Individual (NPI-1)
Name
Marcello A Borzatta
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
May 31, 2006
Certification date
May 24, 2024
Last updated
May 24, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2086S0129X ME97723FLYes
2086S0129X A40479CA

Practice location

2260 S Ferdon Blvd
Crestview, FL 32536-8457

Phone 850-849-1642

Mailing address

2260 S Ferdon Blvd
Crestview, FL 32536-8457

Phone 850-849-1674

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other providers in Crestview, FL