Individual
DR. EDWARD G IZZO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 HAVERFORD AVE, STE 105, SUN CITY CENTER, FL 33573-5200
(813) 258-4533
(813) 258-4733
Mailing address
1901 HAVERFORD AVE, STE 105, SUN CITY CENTER, FL 33573-5200
(813) 258-4533
(813) 258-4733
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
ME0060860
FL
2086S0129X
Vascular Surgery Physician
ME0060860
FL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME0060860
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058349900
—
FL
01
—
14356
IND BX
FL
01
—
2463923
AETNA
FL
01
—
330005522
RR MEDICARE
FL
01
—
593689604
TAX ID
FL
01
—
ME0060860
LICENSE
FL
Enumeration date
06/20/2005
Last updated
11/22/2017
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