Provider Demographics
NPI:1457443509
Name:POLIZZI, LOUIS (DPM)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:POLIZZI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823
Mailing Address - Country:US
Mailing Address - Phone:863-422-2356
Mailing Address - Fax:863-421-0087
Practice Address - Street 1:208 MAIN STREET
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:FL
Practice Address - Zip Code:33823
Practice Address - Country:US
Practice Address - Phone:863-422-2356
Practice Address - Fax:863-421-0087
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1714213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL87894OtherBLUE CROSS BLUE SHIELD
FLCK4240OtherPALMETTO GBA
FL0995330001OtherCIGNA GOVERNMENT SERVICES
FLT55591Medicare UPIN
FL0995330001OtherCIGNA GOVERNMENT SERVICES