Provider Demographics
NPI:1275534398
Name:MILITELLO, JOSEPH CARL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CARL
Last Name:MILITELLO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:120 MEDICAL BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-0220
Mailing Address - Country:US
Mailing Address - Phone:352-683-4500
Mailing Address - Fax:352-683-2210
Practice Address - Street 1:120 MEDICAL BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-0220
Practice Address - Country:US
Practice Address - Phone:352-683-4500
Practice Address - Fax:352-683-2210
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2021-04-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME78744207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107693500Medicaid
FLH78824Medicare UPIN