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General NPI Number Information
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NPI Number | 1497875868
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Entity Type | Individual
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Provider Name | EUGENE LUCAS RIZZO JR. MD
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Gender | Male
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 5425 PARK ST N STE 7W
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City | ST PETERSBURG
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State | FL
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Zip | 33709-7042
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Country | US
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Telephone | 727-202-8140
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Fax | 727-202-8252
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Provider Business Mailing Address
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Address Line | 390 PINELLAS BAYWAY S APT A
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City | TIERRA VERDE
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State | FL
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Zip | 33715-1915
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Country | US
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Telephone | 318-422-1506
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME151604
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License Number State | FL
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