Healthcare Provider Details

I. General information

NPI: 1497875868
Provider Name (Legal Business Name): EUGENE LUCAS RIZZO JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2343 AARON ST
PORT CHARLOTTE FL
33952-5305
US

IV. Provider business mailing address

2675 WINKLER AVE STE 200
FORT MYERS FL
33901-9328
US

V. Phone/Fax

Practice location:
  • Phone: 855-979-5700
  • Fax: 855-979-5701
Mailing address:
  • Phone: 877-856-3774
  • Fax: 855-979-5701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME151604
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: