Provider Demographics
NPI:1639317639
Name:FORCELLA, JOHN ANTHONY JR (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANTHONY
Last Name:FORCELLA
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:11528 US HWY 19
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668
Mailing Address - Country:US
Mailing Address - Phone:727-868-2151
Mailing Address - Fax:727-868-8251
Practice Address - Street 1:9238 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-4853
Practice Address - Country:US
Practice Address - Phone:727-849-8492
Practice Address - Fax:727-849-3472
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10547207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002448600Medicaid
FL21776502OtherWELLMED
FL21776501OtherWELLMED
FL332801OtherAVMED
FL14A51OtherBLUE CROSS BLUE SHIELD
FL2196537OtherCOVENTRY