Healthcare Provider Details

I. General information

NPI: 1598733875
Provider Name (Legal Business Name): LOUIS J CIOCI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6333 N. FEDERAL HWY SUITE 200
FORT LAUDERDALE FL
33308-1900
US

IV. Provider business mailing address

1700 NW 49TH ST STE 125
FORT LAUDERDALE FL
33309-3750
US

V. Phone/Fax

Practice location:
  • Phone: 954-772-0711
  • Fax: 954-229-0711
Mailing address:
  • Phone: 954-772-0711
  • Fax: 954-229-0711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME00661
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: