Healthcare Provider Details

I. General information

NPI: 1386908929
Provider Name (Legal Business Name): PATRICK P CINELLI MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2012
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 TAMPA RD SUITE 101
PALM HARBOR FL
34684-3155
US

IV. Provider business mailing address

2626 TAMPA RD SUITE 101
PALM HARBOR FL
34684-3155
US

V. Phone/Fax

Practice location:
  • Phone: 727-789-2700
  • Fax: 727-789-3541
Mailing address:
  • Phone: 727-789-2700
  • Fax: 727-789-3541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK P CINELLI
Title or Position: DOCTOR
Credential: MD
Phone: 727-789-2700