MEDICARE: J. PAONESSA 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	174400000X	Specialist
2	332B00000X	Durable Medical Equipment & Medical Supplies

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	:	1487848982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J. PAONESSA M.D. P.A.

Provider Business Mailing Address
First Line	:	1201 5TH AVE N
Second Line	:	SUITE 505
City	:	ST PETERSBURG
State	:	FL
Zip	:	33705-1455
Country	:	US
Telephone Number	:	727-821-0017
Fax Number	:	727-502-8860

Provider Business Practice Location Address
First Line	:	303 PINELLAS ST
Second Line	:	SUITE 330
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3809
Country	:	US
Telephone Number	:	727-447-8100
Fax Number	:	727-446-3107

Authorized Official
Title or Position	:	CFO
Name	:	RYAN CIARROCCHI
Credential	:
Telephone Number	:	727-824-4601

Provider Enumeration Date	:	08/29/2007
Last Update Date	:	11/01/2010

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Directions to “J. PAONESSA M.D. P.A. ” Practice Location

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