Provider Demographics
NPI:1508392820
Name:RIZZO, KATHERINE ROSE (DO)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ROSE
Last Name:RIZZO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28465 US HIGHWAY 19 N STE 200
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2511
Mailing Address - Country:US
Mailing Address - Phone:727-600-8093
Mailing Address - Fax:727-240-0604
Practice Address - Street 1:28465 US HIGHWAY 19 N STE 200
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2511
Practice Address - Country:US
Practice Address - Phone:727-600-8093
Practice Address - Fax:727-240-0604
Is Sole Proprietor?:No
Enumeration Date:2017-05-05
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLOS162032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program