Provider Demographics
NPI:1609423789
Name:VINCENZO GIULIANO, MD, LLC
Entity Type:Organization
Organization Name:VINCENZO GIULIANO, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR, CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VICENZO
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-699-7787
Mailing Address - Street 1:5732 CANTON COVE
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5079
Mailing Address - Country:US
Mailing Address - Phone:407-699-7787
Mailing Address - Fax:407-699-7963
Practice Address - Street 1:5732 CANTON COVE
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5079
Practice Address - Country:US
Practice Address - Phone:407-699-7787
Practice Address - Fax:407-699-7963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-22
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257448900Medicaid