Provider Demographics
NPI:1548071525
Name:MARZULLO, FLAVIA MORAES
Entity type:Individual
Prefix:
First Name:FLAVIA
Middle Name:MORAES
Last Name:MARZULLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18228 OLIVER TWIST WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-1814
Mailing Address - Country:US
Mailing Address - Phone:352-818-5701
Mailing Address - Fax:
Practice Address - Street 1:18228 OLIVER TWIST WAY
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-1814
Practice Address - Country:US
Practice Address - Phone:352-818-5701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist