Provider Demographics
NPI:1336940170
Name:BOSCIA, TRAVIS (DPT)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:
Last Name:BOSCIA
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 ARROWGRASS DR UNIT 206
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-4721
Mailing Address - Country:US
Mailing Address - Phone:908-477-4109
Mailing Address - Fax:
Practice Address - Street 1:400 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-5254
Practice Address - Country:US
Practice Address - Phone:863-683-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist