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Individual

DR. JOHN BERTOZZI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1200 7TH AVE N, ST PETERSBURG, FL 33705-1300
(727) 825-1100
(727) 827-5155
Mailing address
PO BOX 919379, ORLANDO, FL 32891-9379
(844) 453-1406
(772) 621-3180

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101244135
VA
2085R0202X
Diagnostic Radiology Physician
Primary
ME95912
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001072200
FL
01
145KF
FL BCBS
FL
01
CC454Z
FL MEDICARE PTAN
FL
01
ME95912
MEDICAL LICENSE
FL
01
P00867622
FL RAILROAD MEDICARE
FL
Enumeration date
08/15/2007
Last updated
08/03/2021
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