Healthcare Provider Details

I. General information

NPI: 1326005174
Provider Name (Legal Business Name): CLIFTON WALTER RIZER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 03/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13205 US HIGHWAY 1 SUITE 109
JUNO BEACH FL
33408-2202
US

IV. Provider business mailing address

790 JUNO OCEAN WALK SUITE 504C
JUNO BEACH FL
33408-1119
US

V. Phone/Fax

Practice location:
  • Phone: 561-627-2525
  • Fax: 561-672-2501
Mailing address:
  • Phone: 561-627-2525
  • Fax: 561-672-2501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT21934
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: