Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS9821 | FL |
N | 207QS0010X | Family Doctor - Sports Medicine | OS9821 | FL |
NPI | 1174566103 |
---|---|
Provider Name | Dr. Jason John Pirozzolo |
First Address | Orlando, FL 32801-5202 |
Second Address | Orlando, FL 32801-5202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 30/11/2011 |