MEDICARE: JOSEPH VITELLO

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
1	237700000X	Hearing Instrument Specialist	AS5388	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790247567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH VITELLO

Provider Business Mailing Address
First Line	:	606 3RD AVE W APT 126
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34205-8683
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7216 MANATEE AVE W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-3439
Country	:	US
Telephone Number	:	941-254-7476
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2019
Last Update Date	:	04/02/2019

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Directions to “ JOSEPH VITELLO ” Practice Location

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