ANTONIO PETRUZZELLA, PHD, LLC
NPI 1801604996
Psychologist - Clinical in Fort Lauderdale, FL

Q: What is Antonio Petruzzella, Phd, LLC's NPI number?

The NPI number for Antonio Petruzzella, Phd, LLC is 1801604996. It was assigned to this organization in the NPPES registry on December 21, 2024. The provider is doing business as Petruzzella Psychology.

Q: What is Antonio Petruzzella, Phd, LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since December 21, 2024

805 E BROWARD BLVD STE 301, FORT LAUDERDALE, FL 33301(954) 300-2195 Get Directions Write a Review

NPPES record last updated: September 6, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 6, 2025, Dec 21, 2024 (2 updates tracked since 2024).

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About Antonio Petruzzella, Phd, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANTONIO PETRUZZELLA, PHD, LLC (NPI 1801604996), doing business as Petruzzella Psychology, is a healthcare organization registered as a clinical in Fort Lauderdale, Florida and active in the NPI registry since December 2024. The organization lists Antonio Petruzzella, Owner, as its authorized official.

NPPES Registry Identity

NPI1801604996

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameANTONIO PETRUZZELLA, PHD, LLC

Location Address805 E BROWARD BLVD STE 301Fort Lauderdale, FL 33301-2046

Mailing Address805 E Broward Blvd Ste 301Fort Lauderdale, FL 33301-2046 · (954) 300-2195

Phone(954) 300-2195

Organization SubpartNo

Authorized OfficialAntonio PetruzzellaOwner · (954) 300-2195

Enumeration DateDecember 21, 2024

Last NPPES UpdateSeptember 6, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 6, 2025

✔ NPI 1801604996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

805 E BROWARD BLVD STE 301, Fort Lauderdale, FL 33301

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Other Names 1

Doing Business AsPetruzzella Psychology

Other Identifiers 1

Other16222832Caqh

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Antonio Petruzzella, Phd, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Antonio Petruzzella, Phd, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Antonio Petruzzella, PHD

Clinical Psychologist

NPI 1184213498

805 E BROWARD BLVD STE 301
Fort Lauderdale, FL 33301

(954) 300-2195

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Antonio Petruzzella, Phd, LLC's NPI number?

The NPI number for Antonio Petruzzella, Phd, LLC is 1801604996. It was assigned to this organization in the NPPES registry on December 21, 2024. The provider is doing business as Petruzzella Psychology.

Where is Antonio Petruzzella, Phd, LLC located?

Antonio Petruzzella, Phd, LLC is located at 805 E Broward Blvd Ste 301, Fort Lauderdale, FL 33301. The listed phone number is (954) 300-2195.

What is Antonio Petruzzella, Phd, LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Antonio Petruzzella, Phd, LLC enrolled in Medicare?

Yes. Antonio Petruzzella, Phd, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Antonio Petruzzella, Phd, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Antonio Petruzzella, Phd, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Antonio Petruzzella, Phd, LLC was last updated on September 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.