Basic Information
Provider Information
NPI: 1649447301
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OZNER-ANDERSON
FirstName: DEBORAH
MiddleName: ALLISON
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: OZNER
OtherFirstName: DEBORAH
OtherMiddleName: ALLISON
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: DO
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 274
Address2:  
City: TERRA CEIA
State: FL
PostalCode: 342500274
CountryCode: US
TelephoneNumber: 3053109124
FaxNumber:  
Practice Location
Address1: 206 2ND ST E
Address2:  
City: BRADENTON
State: FL
PostalCode: 342081042
CountryCode: US
TelephoneNumber: 9417465111
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/13/2008
LastUpdateDate: 03/14/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XOS11672FLY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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