Provider Demographics
NPI:1821876012
Name:PIAZZA, VIVIENNE
Entity Type:Individual
Prefix:
First Name:VIVIENNE
Middle Name:
Last Name:PIAZZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VIVIENNE
Other - Middle Name:
Other - Last Name:PAOLETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3752 TERRAPIN LN APT 2217
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-3130
Mailing Address - Country:US
Mailing Address - Phone:954-732-9857
Mailing Address - Fax:
Practice Address - Street 1:2801 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5727
Practice Address - Country:US
Practice Address - Phone:954-974-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant