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Organization
MARCELLO A BORZATTA MD PA
Active
Organization
MARCELLO A BORZATTA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCELLO A BORZATTA MD (PRESIDENT)
(850) 849-1642
Entity
Organization
Contact information
Practice address
435 BROOKMEADE DR, CRESTVIEW, FL 32539-7304
(850) 305-2105
(239) 663-3061
Mailing address
2260 S FERDON BLVD, CRESTVIEW, FL 32536-8457
(850) 305-2105
(239) 663-3061
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277995100
—
FL
01
—
93788
BCBS
—
Enumeration date
04/13/2007
Last updated
05/24/2024
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