Provider Demographics
NPI:1447267208
Name:RIZZO, DAVID MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:RIZZO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2325 S TAMIAMI TRL STE B
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3807
Mailing Address - Country:US
Mailing Address - Phone:941-217-6864
Mailing Address - Fax:941-217-6868
Practice Address - Street 1:2325 S TAMIAMI TRL STE B
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239
Practice Address - Country:US
Practice Address - Phone:941-217-6864
Practice Address - Fax:941-217-6868
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB070080207Q00000X
FLOS12210207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016510900Medicaid
NJ037328QXNMedicare PIN