MEDICARE: RICHARD A CAPPIELLO M D P A

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	207RR0500X	Rheumatology Physician	ME 45761	FL

General Provider Information

NPI Number	:	1437118676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD A CAPPIELLO M D P A

Provider Business Mailing Address
First Line	:	8188 JOG RD
Second Line	:	SUITE 102
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33472-2952
Country	:	US
Telephone Number	:	561-737-1947
Fax Number	:	561-737-9074

Provider Business Practice Location Address
First Line	:	8188 JOG RD
Second Line	:	SUITE 102
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33472-2952
Country	:	US
Telephone Number	:	561-737-1947
Fax Number	:	561-737-9074

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD A CAPPIELLO
Credential	:	M.D.
Telephone Number	:	561-737-1947

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	12/12/2011

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