Provider Demographics
NPI:1619720745
Name:PETRIZZO, FRANCHESKA LORAINE
Entity Type:Individual
Prefix:
First Name:FRANCHESKA
Middle Name:LORAINE
Last Name:PETRIZZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 DREMA DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-5527
Mailing Address - Country:US
Mailing Address - Phone:407-791-2904
Mailing Address - Fax:
Practice Address - Street 1:3111 DREMA DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-5527
Practice Address - Country:US
Practice Address - Phone:407-791-2904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician