MEDICARE: MICHAEL JON RINALDI DO PA

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	207Y00000X	Otolaryngology Physician	OS7850	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043207640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL JON RINALDI DO PA

Provider Business Mailing Address
First Line	:	5230 WILLING ST
Second Line	:
City	:	MILTON
State	:	FL
Zip	:	32570-4971
Country	:	US
Telephone Number	:	850-983-7778
Fax Number	:	850-983-7785

Provider Business Practice Location Address
First Line	:	150 E REDSTONE AVE
Second Line	:	SUITE B
City	:	CRESTVIEW
State	:	FL
Zip	:	32539-5357
Country	:	US
Telephone Number	:	850-983-7778
Fax Number	:	850-983-7785

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL J RINALDI
Credential	:	DO
Telephone Number	:	850-983-7778

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	06/26/2019

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