Provider Demographics
NPI:1457318982
Name:SAPONARO, JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:SAPONARO
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 1:125 WEST INDIANTOWN ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7200
Mailing Address - Country:US
Mailing Address - Phone:561-575-1212
Mailing Address - Fax:561-745-6664
Practice Address - Street 1:125 W INDIANTOWN RD STE 101
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3539
Practice Address - Country:US
Practice Address - Phone:866-575-1212
Practice Address - Fax:561-745-6664
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME56945207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057414700Medicaid
FLF110650Medicare ID - Type Unspecified
FL057414700Medicaid