Provider Demographics
NPI:1316154727
Name:VIZZONE, FRANK (LMT)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:VIZZONE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20500 COT RD
Mailing Address - Street 2:# 458
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-5100
Mailing Address - Country:US
Mailing Address - Phone:813-948-4923
Mailing Address - Fax:813-948-4923
Practice Address - Street 1:20500 COT RD
Practice Address - Street 2:# 458
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-5100
Practice Address - Country:US
Practice Address - Phone:813-948-4923
Practice Address - Fax:813-948-4923
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA30547174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC3946OtherBCBS