Provider Demographics
NPI:1922404722
Name:PEZZIMENTI, FRANK JOSEPH (PA-C)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:JOSEPH
Last Name:PEZZIMENTI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 NEBRASKA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4832
Mailing Address - Country:US
Mailing Address - Phone:772-465-8100
Mailing Address - Fax:772-465-8689
Practice Address - Street 1:2100 NEBRASKA AVE STE 201
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4832
Practice Address - Country:US
Practice Address - Phone:772-465-8100
Practice Address - Fax:772-465-8689
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC363A00000X
FLPA9112438363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1922404722OtherNPI