Provider Demographics
NPI:1780631283
Name:RICZU, STEVEN A (MSN, ARNP)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:A
Last Name:RICZU
Suffix:
Gender:M
Credentials:MSN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1344 22ND ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-2744
Mailing Address - Country:US
Mailing Address - Phone:727-821-6701
Mailing Address - Fax:727-824-8150
Practice Address - Street 1:1344 22ND ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-2744
Practice Address - Country:US
Practice Address - Phone:727-821-6701
Practice Address - Fax:727-824-8150
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9262306363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000239300Medicaid
FLBF776ZMedicare PIN