Gonzalo Javier Carrizo, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

ME103088 Issued in FL

Practice address

2380 Harbor Blvd
Port Charlotte, FL 33952-5024

Phone

(941) 260-0325

Fax

(941) 766-0423

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Medicare reassignment NPD
• Lawnwood Cardiovascular Surgery LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Fort Pierce, FL
  • NPI 1386724169
  NPD (past)
• Thoracic & Cardiovascular Surgeons LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Atlantis, FL
  • NPI 1649212416
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1801933171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 HARBOR BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525024",
            "telephone_number": "941-260-0325",
            "fax_number": "941-766-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 HARBOR BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525024",
            "telephone_number": "941-260-0325",
            "fax_number": "941-766-0423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Arlington Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436142598",
            "country_code": "US",
            "telephone_number": "419-383-5150",
            "fax_number": "419-383-3149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRIZO",
        "first_name": "GONZALO",
        "middle_name": "JAVIER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OH",
            "license": "35.131527",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL-1905",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME103088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000612700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00717548",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jens Christian Carlsen, DO
• Carlton R. Vollberg M D P a
• Elizabeth Cathrine Carney
• Alan J Carpenter
• Phillip V Carracher, LCSW
• Christina Marie Carson, MS CCC-SLP, MA BCBA
• Daniel Carter, PHARMD.
• Stacy Carter
• Cas Medical Supply, Inc
• Casanova & Casanova MD'S PA

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.