MEDICARE: DR. LOUIS S. GIANNONE D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	PO3077	FL
2	213E00000X	Podiatrist	PO3077	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00080573	OTHER	FL	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	861090573	OTHER	FL	TAX ID
2	65826	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023001492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS S. GIANNONE D.P.M.

Provider Business Mailing Address
First Line	:	411 COMMERCIAL CT STE G
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34292-1650
Country	:	US
Telephone Number	:	941-412-3000
Fax Number	:	941-966-6721

Provider Business Practice Location Address
First Line	:	411 COMMERCIAL CT
Second Line	:	UNIT G
City	:	VENICE
State	:	FL
Zip	:	34292-1650
Country	:	US
Telephone Number	:	941-412-3000
Fax Number	:	941-966-6721

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	01/18/2021

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Directions to “ DR. LOUIS S. GIANNONE D.P.M.” Practice Location

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