Provider Demographics
NPI:1356612659
Name:PIZARRO, MANUEL FRANCO CASTRO III (PT)
Entity type:Individual
Prefix:
First Name:MANUEL
Middle Name:FRANCO CASTRO
Last Name:PIZARRO
Suffix:III
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 CARLETON ST
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4504
Mailing Address - Country:US
Mailing Address - Phone:863-837-0003
Mailing Address - Fax:
Practice Address - Street 1:121 CARLETON ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4504
Practice Address - Country:US
Practice Address - Phone:863-837-0003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27011225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist