Individual
GARY F PASTIZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9332 STATE ROAD 54 STE 405, TRINITY, FL 34655-1810
(727) 375-8264
Mailing address
18951 ROSEATE DR, LUTZ, FL 33558-2316
(860) 604-2998
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
000626
CT
363A00000X
Physician Assistant
PA9110033
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9110033
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003006269
—
CT
01
—
00420017701
ANTHEM BLUE CROSS
—
01
—
010626
CONNECTICARE
CT
01
—
290000626CT02
ANTHEM BLUE CROSS
—
01
—
2V6674
HEALTH NET
CT
01
—
P3501542
OXFORD
CT
Enumeration date
08/30/2005
Last updated
09/30/2024
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