Provider Demographics
NPI:1467092353
Name:RIZZO, EMILY (LM, CPM)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:RIZZO
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 S BLOXAM AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34715-8709
Mailing Address - Country:US
Mailing Address - Phone:813-469-3724
Mailing Address - Fax:
Practice Address - Street 1:104 S BLOXAM AVE
Practice Address - Street 2:
Practice Address - City:MINNEOLA
Practice Address - State:FL
Practice Address - Zip Code:34715-8709
Practice Address - Country:US
Practice Address - Phone:813-469-3724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW389176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife