MEDICARE: BRIELLE CIONI APN

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	363LF0000X	Family Nurse Practitioner	209012798	IL
2	363LF0000X	Family Nurse Practitioner	9405247	FL

General Provider Information

NPI Number	:	1265810212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIELLE CIONI APN

Provider Business Mailing Address
First Line	:	4743 SE 35TH ST
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34480-1664
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4743 SE 35TH ST
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34480-1664
Country	:	US
Telephone Number	:	608-312-9156
Fax Number	:

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

Provider Enumeration Date	:	05/11/2015
Last Update Date	:	08/28/2022

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