Provider Demographics
NPI:1316507668
Name:PIZARRO, ROLANDO LUIS (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:ROLANDO
Middle Name:LUIS
Last Name:PIZARRO
Suffix:
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8870 NW 36TH ST APT 3306
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3541
Mailing Address - Country:US
Mailing Address - Phone:787-435-6539
Mailing Address - Fax:
Practice Address - Street 1:9393 SW 72ND ST APT 3306
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3204
Practice Address - Country:US
Practice Address - Phone:787-435-6539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL63252255A2300X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer