Iannotti, Nicholas Oswald

Iannotti, Nicholas Oswald is an individual health care provider with primary practice located at 1871 Se Tiffany Ave Suite 100, Port St Lucie FL 34952-7585. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Iannotti, Nicholas Oswald can be contacted via phone (772) 335-5666.

Contact Information

Primary practice address
1871 Se Tiffany Ave Suite 100 Port St Lucie FL 34952-7585
Phone: (772) 335-5666
Fax: (772) 335-4826
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 0054918 Florida

Profile Details

NPI number 1154360642
LBN Legal business name Iannotti, Nicholas Oswald
Credentials MD, FACP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Jun 15th, 2010 - about 16 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 1154360642 NPPES
Florida Other 08210 BLUE CROSS BLUE SHIELD
Florida Other 830003199 BLUE CROSS BLUE SHIELD
Florida Other 0054918 BLUE CROSS BLUE SHIELD
Florida MEDICAID 064733100 BLUE CROSS BLUE SHIELD

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