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NPI Code Detail

MEDICARE: DR. FRANK JOSEPH LISTELLO JR. M.D.

MEDICARE:  DR. FRANK JOSEPH LISTELLO JR. M.D.
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
1207R00000XInternal Medicine PhysicianME81115FL

General Provider Information

NPI Number : 1417950429
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FRANK JOSEPH LISTELLO JR. M.D.
Provider Business Mailing Address
First Line : 1930 ADMIRALTY BLVD
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32955-5213
Country : US
Telephone Number : 321-632-4407
Fax Number :
Provider Business Practice Location Address
First Line : 6300 N WICKHAM RD
Second Line : STE 101
City : MELBOURNE
State : FL
Zip : 32940-2023
Country : US
Telephone Number : 321-253-2169
Fax Number : 321-253-1720
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 01/07/2011

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Directions to “ DR. FRANK JOSEPH LISTELLO JR. M.D.” Practice Location

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