MEDICARE: PETER IZZO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME170463	FL
2	207Q00000X	Family Medicine Physician	74070	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063755700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER IZZO M.D.

Provider Business Mailing Address
First Line	:	8315 RED BUG LAKE RD
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-6860
Country	:	US
Telephone Number	:	407-599-6193
Fax Number	:	407-599-6194

Provider Business Practice Location Address
First Line	:	8315 RED BUG LAKE RD
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-6860
Country	:	US
Telephone Number	:	407-599-6193
Fax Number	:	407-599-6194

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2013
Last Update Date	:	02/08/2026

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