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General NPI Number Information
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NPI Number | 1578599528
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Entity Type | Individual
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Provider Name | PAUL JAMES CAPOBIANCO D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 3472 NE SAVANNAH RD.
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City | JENSEN BEACH
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State | FL
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Zip | 34957
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Country | US
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Telephone | 516-435-5260
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Fax |
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Provider Business Mailing Address
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Address Line | 1820 NE JENSEN BEACH BLVD # 512
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City | JENSEN BEACH
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State | FL
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Zip | 34957-7212
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Country | US
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Telephone | 516-435-5260
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Fax |
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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 | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 199975-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS16010
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 199975-1
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | OS16010
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License Number State | FL
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