Antonio Petruzzella, PHD, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

ANTONIO PETRUZZELLA, PHD, LLC

Doing business as

Petruzzella Psychology

Practice address

805 E Broward Blvd Ste 301
Fort Lauderdale, FL 33301-2046

Phone

(954) 300-2195

NPI assigned

Dec 21, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Antonio Petruzzella, PHDNPI 1184213498

Title

Owner

Phone

(954) 300-2195

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Petruzzella Psychology Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Antonio Petruzzella, PHD

  • Clinical Psychologist
  • Fort Lauderdale, FL
  • NPI 1184213498
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757116800000",
    "number": "1801604996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 E BROWARD BLVD STE 301",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012046",
            "telephone_number": "954-300-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E BROWARD BLVD STE 301",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012046",
            "telephone_number": "954-300-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTONIO PETRUZZELLA, PHD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-21",
        "last_updated": "2025-09-06",
        "certification_date": "2025-09-06",
        "status": "A",
        "authorized_official_last_name": "PETRUZZELLA",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-300-2195",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "16222832",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Petruzzella Psychology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel Ryan Antohi, MD
• Darfney Antoine
• Robert Antoine, MD
• Manuel Patricio Anton III, M.D.
• Antonio G. Revilla Jr., M.D. P.a.
• Irina Antonova, PHARMD
• Anuj Khanna, DO. PA.
• Chisom Ihuoma Anyanwoke
• Anywhere Clinic Medical PLLC
• Alejandra Anzola

• Clinical Psychologist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.