Provider Demographics
NPI:1669665204
Name:HERNANDEZ PIZZINI, GIANCARLOS (ATC)
Entity Type:Individual
Prefix:
First Name:GIANCARLOS
Middle Name:
Last Name:HERNANDEZ PIZZINI
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9235 LAGOON PL APT 303
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-6725
Mailing Address - Country:US
Mailing Address - Phone:954-476-3671
Mailing Address - Fax:
Practice Address - Street 1:4137 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4528
Practice Address - Country:US
Practice Address - Phone:561-395-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL23512255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer