Provider Demographics
NPI:1821253055
Name:PIZARRO, ROXANNA (PTA)
Entity Type:Individual
Prefix:MS
First Name:ROXANNA
Middle Name:
Last Name:PIZARRO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 HARBOR DR S
Mailing Address - Street 2:UNIT B
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-3120
Mailing Address - Country:US
Mailing Address - Phone:941-468-1891
Mailing Address - Fax:941-483-9190
Practice Address - Street 1:3417 TAMIAMI TRL STE A
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8158
Practice Address - Country:US
Practice Address - Phone:941-624-6222
Practice Address - Fax:941-624-6821
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA16365225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant