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General NPI Number Information
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NPI Number | 1043457666
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Entity Type | Organization
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Legal Business Name | J. PAONESSA M.D. P.A.
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Dates
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Enumeration Date | 01/20/2009
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 100 HIGHLAND AVE N
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City | LARGO
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State | FL
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Zip | 33770-2542
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Country | US
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Telephone | 727-683-2900
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Fax | 727-683-2901
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Provider Business Mailing Address
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Address Line | 1201 5TH AVE N SUITE 505
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City | ST PETERSBURG
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State | FL
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Zip | 33705-1455
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Country | US
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Telephone | 727-821-0017
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Fax | 727-502-8860
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Authorized Official
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Title or Position | CFO
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Name | RYAN CIARROCCHI
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Credential |
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Telephone | 727-824-4601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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