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General NPI Number Information
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NPI Number | 1699059808
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Entity Type | Organization
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Legal Business Name | PEZZONE GASTROENTEROLOGY ASSOCIATES PC
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 10/17/2016
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Provider Practice Location Address
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Address Line | 1400 N US HIGHWAY 441 STE 810
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City | THE VILLAGES
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State | FL
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Zip | 32159-8987
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Country | US
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Telephone | 352-674-8700
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Fax | 352-674-8714
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Provider Business Mailing Address
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Address Line | 1400 N US HIGHWAY 441 STE 810
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City | THE VILLAGES
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State | FL
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Zip | 32159-8987
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Country | US
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Telephone | 352-674-8700
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Fax | 352-674-8714
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL ANGELO PEZZONE
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Credential | M.D.
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Telephone | 352-674-8700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD060508L
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License Number State | PA
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