MEDICARE: VINCENT PIANELLI, MDPA

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	207R00000X	Internal Medicine Physician	ME0014100	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	06830	OTHER	FL	MEDICARE ID

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

General Provider Information

NPI Number	:	1194979963
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VINCENT PIANELLI, MDPA

Provider Business Mailing Address
First Line	:	PO BOX 23158
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33307-3158
Country	:	US
Telephone Number	:	954-522-8561
Fax Number	:	954-522-6602

Provider Business Practice Location Address
First Line	:	935 INTRACOASTAL DRIVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304
Country	:	US
Telephone Number	:	954-522-8561
Fax Number	:	954-522-6602

Authorized Official
Title or Position	:	OWNER
Name	:	GEORGE G BOCTOR
Credential	:	MD
Telephone Number	:	954-776-1180

Provider Enumeration Date	:	11/06/2008
Last Update Date	:	04/25/2023

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Directions to “VINCENT PIANELLI, MDPA ” Practice Location

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