Provider Demographics
NPI:1548009988
Name:AZZI ENT & FACIAL RECONSTRUCTIVE SURGERY PA
Entity type:Organization
Organization Name:AZZI ENT & FACIAL RECONSTRUCTIVE SURGERY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:AZZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-486-4790
Mailing Address - Street 1:2151 S ALT A1A STE 425
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-4070
Mailing Address - Country:US
Mailing Address - Phone:561-979-2001
Mailing Address - Fax:561-462-0852
Practice Address - Street 1:2151 S ALT A1A STE 425
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-4070
Practice Address - Country:US
Practice Address - Phone:561-979-2001
Practice Address - Fax:561-462-0852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty