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General NPI Number Information
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NPI Number | 1942372917
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Entity Type | Individual
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Provider Name | CARL P. PIZZARELLO O.D.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1675 NW SAINT LUCIE WEST BLVD
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City | PORT ST LUCIE
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State | FL
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Zip | 34986-2106
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Country | US
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Telephone | 772-785-8182
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Fax | 772-873-9458
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Provider Business Mailing Address
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Address Line | 183 NW MAGNOLIA LAKES BLVD
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City | PORT ST LUCIE
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State | FL
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Zip | 34986-3568
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Country | US
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Telephone | 772-343-1621
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Fax | 772-873-9458
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC 3568
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OPC 3568
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number | OPC 3568
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License Number State | FL
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