Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | SW8851 | FL |
NPI | 1003086489 |
---|---|
Provider Name | Mr. Daryl D Bozone |
First Address | Dade City, FL 33525-8008 |
Second Address | Dade City, FL 33525-8008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2008 |
Last Update Date | 26/12/2012 |