Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME143567 | FL |
Y | 207XS0117X | Orthopaedic Spine Surgeon | ME143567 | FL |
NPI | 1225065014 |
---|---|
Provider Name | Steven J Rizzolo |
First Address | Jacksonville, FL 32244-5597 |
Second Address | Orange Park, FL 32073-4898 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 13/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000006101 | BLUE CROSS (01) | MT |
0099424 | (05) | MT |
1225065014 | (05) | MT |
433416 | (05) | AZ |
E83380 | (02) |