Provider Demographics
NPI:1598720930
Name:LOUIS S. GIANNONE, DPM PLLC
Entity Type:Organization
Organization Name:LOUIS S. GIANNONE, DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:GIANNONE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:941-223-8968
Mailing Address - Street 1:518 BAYSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:NOKOMIS
Mailing Address - State:FL
Mailing Address - Zip Code:34275-3439
Mailing Address - Country:US
Mailing Address - Phone:941-223-8968
Mailing Address - Fax:941-966-6721
Practice Address - Street 1:1201 JACARANDA BLVD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-4535
Practice Address - Country:US
Practice Address - Phone:941-223-8968
Practice Address - Fax:941-966-6721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID