Provider Demographics
NPI:1124446554
Name:RIZZO, JASON (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:RIZZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:295 SPINDRIFT DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4701
Mailing Address - Country:US
Mailing Address - Phone:716-831-2600
Mailing Address - Fax:716-831-2601
Practice Address - Street 1:23471 WALDEN CENTER DR STE 300
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:34134-5016
Practice Address - Country:US
Practice Address - Phone:239-498-3376
Practice Address - Fax:239-498-3379
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY296429-1207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology