Provider Demographics
NPI:1558522029
Name:RIZZO, KRISTIN K (DPM)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:K
Last Name:RIZZO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:D
Other - Last Name:KELLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5302 HARRIS CIR
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-3709
Mailing Address - Country:US
Mailing Address - Phone:407-865-4668
Mailing Address - Fax:
Practice Address - Street 1:5201 RAYMOND ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-8208
Practice Address - Country:US
Practice Address - Phone:321-397-6965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD1105213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery