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NPI Code Detail

MEDICARE: DR. MARCO VALERIO CANULLA MD

MEDICARE: DR. MARCO VALERIO CANULLA MD
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
1208600000XSurgery Physician38460OK
2208600000XSurgery Physician24230AZ

Other Identifiers

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

General Provider Information

NPI Number : 1194700286
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARCO VALERIO CANULLA MD
Provider Business Mailing Address
First Line : PO BOX 21647
Second Line :
City : TAMPA
State : FL
Zip : 33622-1647
Country : US
Telephone Number : 405-696-0030
Fax Number :
Provider Business Practice Location Address
First Line : 14044 W CAMELBACK RD STE 118
Second Line :
City : LITCHFIELD PARK
State : AZ
Zip : 85340-9481
Country : US
Telephone Number : 623-584-4882
Fax Number : 623-584-6732
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2005
Last Update Date : 08/31/2021

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Directions to “ DR. MARCO VALERIO CANULLA MD” Practice Location

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