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NPI Code Detail

MEDICARE: DR. JOHN ANTHONY FORCELLA JR. D.O.

MEDICARE: DR. JOHN ANTHONY FORCELLA JR. D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RI0011XInterventional Cardiology PhysicianOS10547FL
2207RC0000XCardiovascular Disease PhysicianOS10547FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
221776502OTHERFLWELLMED
321776501OTHERFLWELLMED
4332801OTHERFLAVMED
514A51OTHERFLBLUE CROSS BLUE SHIELD
62196537OTHERFLCOVENTRY

General Provider Information

NPI Number : 1639317639
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN ANTHONY FORCELLA JR. D.O.
Provider Business Mailing Address
First Line : 11528 US HWY 19
Second Line :
City : PORT RICHEY
State : FL
Zip : 34668
Country : US
Telephone Number : 727-868-2151
Fax Number : 727-868-8251
Provider Business Practice Location Address
First Line : 9238 US HIGHWAY 19
Second Line :
City : PORT RICHEY
State : FL
Zip : 34668-4853
Country : US
Telephone Number : 727-849-8492
Fax Number : 727-849-3472
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2009
Last Update Date : 07/21/2022

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