Ciccarello, Jimmie Ignazio

Ciccarello, Jimmie Ignazio is an sole proprietor health care provider with primary practice located at 620 Seaside Dr , Tarpon Springs FL 34689-2293. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ciccarello, Jimmie Ignazio can be contacted via phone (609) 458-4541.

Contact Information

Primary practice address
620 Seaside Dr Tarpon Springs FL 34689-2293
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 27OA00545000 New Jersey
Eye and Vision Services Providers / Optometrist 152W00000X OPC 5167 Florida

Profile Details

NPI number 1144264110
LBN Legal business name Ciccarello, Jimmie Ignazio
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 16th, 2006
Last updated Apr 18th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144264110 NPPES
New Jersey Other 2204890 AETNA
New Jersey Other NJ5450 AETNA

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