MEDICARE: ANTHONY OTTAVIANI D.O.

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	207RP1001X	Pulmonary Disease Physician	OS3300	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	81895	OTHER	FL	BCBS BLUE CARE, ADVANTAGE 65 SELECT, MEDICARE PPO/HMO, GO BLUE
2	10316	OTHER	FL	FLORIDA WELLCARE (MEDICARE PLAN)
4	388453	OTHER	FL	UNITED HEALTHCARE COMMERCIAL AND MEDICARE PLANS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	81895	OTHER	FL	OUT OF STATE BLUE CROSS BLUE SHIELD
5	81895	OTHER	FL	BLUE OPTIONS, BLUE CHOICE, FEDERAL, FLORIDA STATE AND TRADITIONAL BCBS
6	0678454	OTHER	FL	CIGNA PPO/HMO, OPEN ACCESS
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	591273247	OTHER		UHC NY STATE EMPIRE PLAN
9	738136	OTHER		MAIL HANDLERS BENEFIT PLAN (MHBP)

General Provider Information

NPI Number	:	1467441451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY OTTAVIANI D.O.

Provider Business Mailing Address
First Line	:	201 14TH ST SW
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33770-3133
Country	:	US
Telephone Number	:	727-204-4893
Fax Number	:	727-585-7205

Provider Business Practice Location Address
First Line	:	201 14TH ST SW
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33770-3133
Country	:	US
Telephone Number	:	727-204-4893
Fax Number	:	727-585-7205

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	03/29/2017

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