Provider Demographics
NPI:1023001492
Name:GIANNONE, LOUIS S (DPM)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:S
Last Name:GIANNONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 COMMERCIAL CT STE G
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-1650
Mailing Address - Country:US
Mailing Address - Phone:941-412-3000
Mailing Address - Fax:941-966-6721
Practice Address - Street 1:411 COMMERCIAL CT
Practice Address - Street 2:UNIT G
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1650
Practice Address - Country:US
Practice Address - Phone:941-412-3000
Practice Address - Fax:941-966-6721
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3077213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL861090573OtherTAX ID
FL65826OtherBCBS
FL340426900Medicaid
FLP00080573OtherMEDICARE RR
FLU63104Medicare UPIN
FLP00080573OtherMEDICARE RR