Provider Demographics
NPI:1053310441
Name:DINAPOLI, PETER THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:THOMAS
Last Name:DINAPOLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34629 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2152
Mailing Address - Country:US
Mailing Address - Phone:727-785-7674
Mailing Address - Fax:727-785-0861
Practice Address - Street 1:34629 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2152
Practice Address - Country:US
Practice Address - Phone:727-785-7674
Practice Address - Fax:727-785-0861
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0046342174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL040165000Medicaid
FL040165000Medicaid
FLD21865Medicare UPIN