MEDICARE: GIOVANNI M. BAULA 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
1	207R00000X	Internal Medicine Physician	ME77177	FL

General Provider Information

NPI Number	:	1699760181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIOVANNI M. BAULA M.D.

Provider Business Mailing Address
First Line	:	2849 SEABREEZE DR S
Second Line	:
City	:	GULFPORT
State	:	FL
Zip	:	33707-3931
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2849 SEABREEZE DR S
Second Line	:
City	:	GULFPORT
State	:	FL
Zip	:	33707-3931
Country	:	US
Telephone Number	:	727-000-0000
Fax Number	:

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	05/28/2024

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