Provider Demographics
NPI:1467472001
Name:MARCONI, ADAM LOUIS II
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:LOUIS
Last Name:MARCONI
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2153 BOXWOOD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34289-1403
Mailing Address - Country:US
Mailing Address - Phone:941-429-2149
Mailing Address - Fax:
Practice Address - Street 1:2650 BAHIA VISTA ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2635
Practice Address - Country:US
Practice Address - Phone:941-365-2830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT6739225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5144793OtherATENA NON HMO
FLP00272541OtherRAILROAD MEDICARE
PA966449OtherPA BCBS
FLY4395OtherBLUE CROSS BLUE SHIELD
FL2192216OtherATENA HMO
FL640076OtherPCA
FLS2078OtherPRINCIPLE
PA966449OtherPA BCBS