Provider Demographics
NPI:1700516853
Name:PIZIK, LAWRENCE JAY (RPH)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:JAY
Last Name:PIZIK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 NW 91ST WAY
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8521
Mailing Address - Country:US
Mailing Address - Phone:954-371-6122
Mailing Address - Fax:
Practice Address - Street 1:6950 CYPRESS RD STE 105
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2361
Practice Address - Country:US
Practice Address - Phone:954-316-5054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS169321835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS16932OtherSTATE LICENSE