Organization
GIANCARLO BERTOZZI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GIANCARLO BERTOZZI MD (PHYSICIAN/SURGEON/OWNER)
(904) 396-2421
Entity
Organization
Contact information
Practice address
3599 UNIVERSITY BLVD S STE 802, JACKSONVILLE, FL 32216-4258
(904) 396-2421
(904) 398-1854
Mailing address
3599 UNIVERSITY BLVD S STE 802, JACKSONVILLE, FL 32216-4258
(904) 396-2421
(904) 398-1854
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME 20514
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054722100
—
FL
Enumeration date
08/19/2010
Last updated
08/19/2010
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