Provider Demographics
NPI:1104889385
Name:BOCCIO, SOL (LMT)
Entity type:Individual
Prefix:
First Name:SOL
Middle Name:
Last Name:BOCCIO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5108 15TH ST E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-4846
Mailing Address - Country:US
Mailing Address - Phone:941-751-8140
Mailing Address - Fax:941-751-8142
Practice Address - Street 1:5108 15TH ST E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-4886
Practice Address - Country:US
Practice Address - Phone:941-751-8140
Practice Address - Fax:941-751-8142
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLMA33097225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist