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General NPI Number Information
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NPI Number | 1447499082
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Entity Type | Individual
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Provider Name | PAUL DOMINIC LOPREATO P.A.
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Gender | Male
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 1051 PORT MALABAR BLVD NE STE 6-7
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City | PALM BAY
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State | FL
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Zip | 32905-5153
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Country | US
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Telephone | 800-735-1178
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Fax | 772-223-6354
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Provider Business Mailing Address
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Address Line | 3699 ALEXANDRIA PIKE
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City | ALEXANDRIA
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State | KY
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Zip | 41076-5121
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Country | US
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Telephone | 859-442-8444
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Fax | 859-442-8777
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9109473
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License Number State | FL
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