Provider Demographics
NPI:1962211821
Name:PINIZZOTTO, PHILIP (MA)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:PINIZZOTTO
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2229 BODRICK CIR APT 102
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-1248
Mailing Address - Country:US
Mailing Address - Phone:386-872-8132
Mailing Address - Fax:
Practice Address - Street 1:6515 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-5713
Practice Address - Country:US
Practice Address - Phone:813-359-1995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health