DR. ANTONIO PETRUZZELLA (PHD) – Clinical Psychologist, NPI 1184213498

DR. ANTONIO PETRUZZELLA (PHD) is a healthcare provider. based in Fort lauderdale, Florida. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. PY11566 (FL). The NPI Number for DR. ANTONIO PETRUZZELLA (PHD) is 1184213498

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
DR. ANTONIO PETRUZZELLA (PHD)
NPI
1184213498
Phone
Not provided
Address
805 E BROWARD BLVD STE 301
Enumeration Date
12 January 2021
Last Update Date
6 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9543002195
Graduation Year
2021 (5 years ago)
PAC ID
5294232500
Professional Enrollment ID
I20251010002224
Address ID
FL333012046FO805XXBLVD404
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:5State licenses:1Digital endpointsOther names

1,602 CLINICAL PSYCHOLOGIST in FL

Provider Addresses for DR. ANTONIO PETRUZZELLA (PHD)

  • 805 E BROWARD BLVD STE 301

    FORT LAUDERDALE, FL 333012046

    Phone:

    Type: Mailing

  • 7602 RIDGE RD APT 103D

    SEMINOLE, FL 337725234

    Phone: (201) 805-5112

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251010002224IClinical PsychologistFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33301)

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Reviews

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Frequently asked questions

Does DR. ANTONIO PETRUZZELLA (PHD) have a public NPI I can cite?
Public records show DR. ANTONIO PETRUZZELLA (PHD) under NPI 1184213498.
Is DR. ANTONIO PETRUZZELLA (PHD) currently accepting referrals based on NPI status?
Registry metadata lists DR. ANTONIO PETRUZZELLA (PHD) as active.
What type of care does DR. ANTONIO PETRUZZELLA (PHD) provide?
DR. ANTONIO PETRUZZELLA (PHD)'s profile centers on Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. ANTONIO PETRUZZELLA (PHD)?
DR. ANTONIO PETRUZZELLA (PHD) shows a connection to Fort Lauderdale, Florida in registry-derived data.
Why is information missing for DR. ANTONIO PETRUZZELLA (PHD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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