Provider Demographics
NPI:1861877367
Name:LOZZI, EDWARD (PT)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:LOZZI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 HERITAGE TRL STE 301
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-8716
Mailing Address - Country:US
Mailing Address - Phone:239-649-6848
Mailing Address - Fax:239-649-6773
Practice Address - Street 1:1725 HERITAGE TRL STE 301
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-8716
Practice Address - Country:US
Practice Address - Phone:239-649-6848
Practice Address - Fax:239-649-6773
Is Sole Proprietor?:No
Enumeration Date:2015-07-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 60563579225100000X
FLPT30014225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT30014OtherSTATE OF FLORIDA