Provider Demographics
NPI:1457901928
Name:DELPIZZO SR., TERRY
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:DELPIZZO SR.
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 NE NOAH ST
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-1259
Mailing Address - Country:US
Mailing Address - Phone:440-547-6942
Mailing Address - Fax:
Practice Address - Street 1:559 NE NOAH ST
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-1259
Practice Address - Country:US
Practice Address - Phone:440-547-6942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-17
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider