MEDICARE: LAURA PIZZURRO, LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1356059406
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAURA PIZZURRO, LLC

Provider Business Mailing Address
First Line	:	4125 APPLE BLOSSOM RD
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-2719
Country	:	US
Telephone Number	:	561-558-3611
Fax Number	:

Provider Business Practice Location Address
First Line	:	4125 APPLE BLOSSOM RD
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-2719
Country	:	US
Telephone Number	:	561-558-3611
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LAURA PIZZURRO
Credential	:
Telephone Number	:	561-558-3611

Provider Enumeration Date	:	11/08/2022
Last Update Date	:	11/08/2022

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