Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | ME52123 | FL |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | ME52123 | FL |
NPI | 1578560611 |
---|---|
Provider Name | Dr. John Joseph Pirrello |
First Address | Bayonet Point, FL 34667 |
Second Address | Bayonet Point, FL 34667 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 04/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E67466 | (02) |