IndividualActive
Anngelique Bizzaro, OD
NPI 1811636228 · Optometrist · South Jordan, UT
Provider details
- NPI number
- 1811636228
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Credential
- OD
- Sex
- Female
- Sole proprietor
- No
- License
- 12872545-9934 (UT)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
11514 S 4000 W Ste 103
South Jordan, UT 84009-6016
Phone: (801) 214-0327
Approximate (ZIP-level) locationGet directions
Mailing address
11514 S 4000 W Ste 103
South Jordan, UT 84009-6016
Registry dates
- Enumerated
- 2022-06-02
- Last updated
- 2022-06-02
- Certified
- 2022-05-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.