Provider Demographics
NPI:1598733875
Name:CIOCI, LOUIS J (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:J
Last Name:CIOCI
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 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-772-0711
Mailing Address - Fax:954-229-0711
Practice Address - Street 1:6333 N. FEDERAL HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1900
Practice Address - Country:US
Practice Address - Phone:954-772-0711
Practice Address - Fax:954-229-0711
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00661207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000766800Medicaid
F71349Medicare UPIN
FL000766800Medicaid