Healthcare Provider Details

I. General information

NPI: 1922628437
Provider Name (Legal Business Name): JOHN A FLAUTO DPM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 04/27/2020
Certification Date: 04/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 SOUTH AVE STE 3
BOARDMAN OH
44512-3603
US

IV. Provider business mailing address

7010 SOUTH AVE STE 3
BOARDMAN OH
44512-3603
US

V. Phone/Fax

Practice location:
  • Phone: 330-729-1200
  • Fax:
Mailing address:
  • Phone: 330-729-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JOHN FLAUTO
Title or Position: OWNER
Credential: MD
Phone: 330-729-1200