Provider Demographics
NPI:1093712176
Name:NATOLI, BARTHOLOMEW F (MD)
Entity Type:Individual
Prefix:DR
First Name:BARTHOLOMEW
Middle Name:F
Last Name:NATOLI
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 1:9009 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33777-4152
Mailing Address - Country:US
Mailing Address - Phone:727-391-6650
Mailing Address - Fax:
Practice Address - Street 1:9009 PARK BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33777-4152
Practice Address - Country:US
Practice Address - Phone:727-391-6650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55345207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL051250800Medicaid
FLK1028Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
FL051250800Medicaid
FLE22073Medicare UPIN