Provider Demographics
NPI:1326005174
Name:RIZER, CLIFTON WALTER (PT)
Entity Type:Individual
Prefix:
First Name:CLIFTON
Middle Name:WALTER
Last Name:RIZER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 JUNO OCEAN WALK
Mailing Address - Street 2:SUITE 504C
Mailing Address - City:JUNO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-1119
Mailing Address - Country:US
Mailing Address - Phone:561-627-2525
Mailing Address - Fax:561-672-2501
Practice Address - Street 1:13205 US HIGHWAY 1
Practice Address - Street 2:SUITE 109
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-2202
Practice Address - Country:US
Practice Address - Phone:561-627-2525
Practice Address - Fax:561-672-2501
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21934225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14088ZMedicare UPIN