Healthcare Provider Details

I. General information

NPI: 1891916789
Provider Name (Legal Business Name): JOSEPH AARON CIPRIANO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2546 HEYDON LN
CAPE CORAL FL
33991-3550
US

IV. Provider business mailing address

2546 HEYDON LN STE 2
CAPE CORAL FL
33991-3550
US

V. Phone/Fax

Practice location:
  • Phone: 941-999-1009
  • Fax: 855-574-2200
Mailing address:
  • Phone: 239-317-0333
  • Fax: 855-574-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number5101016438
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2015-00897
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS14824
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: