Provider Demographics
NPI:1356819007
Name:RIZO, RICHARD (NP)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:RIZO
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 N UNIVERSITY DR STE 350
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6000
Mailing Address - Country:US
Mailing Address - Phone:954-227-2700
Mailing Address - Fax:954-227-2704
Practice Address - Street 1:1725 N UNIVERSITY DR STE 350
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6000
Practice Address - Country:US
Practice Address - Phone:954-227-2700
Practice Address - Fax:954-227-2704
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-09
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL000000000363L00000X
FLAPRN11005478363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner