Healthcare Provider Details

I. General information

NPI: 1386081206
Provider Name (Legal Business Name): FRANCESCO PAOLO CAPORUSSO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2013
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 AUBURN AVE
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

170 FLUSHING AVE
WOODBRIDGE ON
487
CA

V. Phone/Fax

Practice location:
  • Phone: 513-585-0577
  • Fax:
Mailing address:
  • Phone: 905-265-9575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35.133588
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR73975
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: