Healthcare Provider Details

I. General information

NPI: 1770713943
Provider Name (Legal Business Name): GIOVANNI PIOVESANA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8333 N DAVIS HWY FL 9
PENSACOLA FL
32514-6050
US

IV. Provider business mailing address

8333 N DAVIS HWY FL 9
PENSACOLA FL
32514-6050
US

V. Phone/Fax

Practice location:
  • Phone: 850-969-7979
  • Fax: 850-969-1839
Mailing address:
  • Phone: 850-969-7979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberBP1-0034820
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number075870
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberME124155
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: