Provider Demographics
NPI:1467543231
Name:CIOTTI, JOHN LAWRENCE JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LAWRENCE
Last Name:CIOTTI
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 GUNWALE LN
Mailing Address - Street 2:
Mailing Address - City:LONGBOAT KEY
Mailing Address - State:FL
Mailing Address - Zip Code:34228-3710
Mailing Address - Country:US
Mailing Address - Phone:228-327-7801
Mailing Address - Fax:
Practice Address - Street 1:205 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-1500
Practice Address - Country:US
Practice Address - Phone:941-259-4544
Practice Address - Fax:941-822-8016
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11197111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5291607OtherAETNA
MS00121777Medicaid
MS09015198Medicaid
MS350000339Medicare ID - Type Unspecified
5291607OtherAETNA