Provider Demographics
NPI:1508852773
Name:STAFFETTI, JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:STAFFETTI
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 1:10820 STATE ROAD 54
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-2291
Mailing Address - Country:US
Mailing Address - Phone:727-846-7031
Mailing Address - Fax:727-846-7132
Practice Address - Street 1:10820 STATE ROAD 54
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-2291
Practice Address - Country:US
Practice Address - Phone:727-846-7031
Practice Address - Fax:727-846-7132
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0062456207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370568400Medicaid
FLE48949Medicare UPIN