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Individual

LISA MAZZATTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
220 N SYKES CREEK PKWY STE 300, MERRITT ISLAND, FL 32953-3490
(321) 459-0303
Mailing address
140 RIVER PARK BLVD, TITUSVILLE, FL 32780-8129
(321) 267-0033

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTA 18541
LICENSE #
FL
Enumeration date
08/30/2006
Last updated
07/08/2007
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