Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | PO3077 | FL |
N | 222Z00000X | Podiatrist | PO3077 | FL |
Y | 213ES0131X | Foot Surgery | PO3077 | FL |
NPI | 1023001492 |
---|---|
Provider Name | Dr. Louis S. Giannone |
First Address | Venice, FL 34292-1650 |
Second Address | Venice, FL 34292-1650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 18/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
340426900 | (05) | FL |
65826 | BCBS (01) | FL |
861090573 | TAX ID (01) | FL |
P00080573 | MEDICARE RR (01) | FL |
U63104 | (02) | FL |