Provider Demographics
NPI:1275516783
Name:GIANGRECO, ALFREDO A (MD)
Entity Type:Individual
Prefix:MR
First Name:ALFREDO
Middle Name:A
Last Name:GIANGRECO
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 1:4861 27TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-1726
Mailing Address - Country:US
Mailing Address - Phone:941-755-0800
Mailing Address - Fax:941-755-1905
Practice Address - Street 1:4861 27TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-1726
Practice Address - Country:US
Practice Address - Phone:941-755-0800
Practice Address - Fax:941-755-1905
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0042925174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79855OtherBCBS
FL14853OtherSTAYWELL
FL4297121OtherAETNA