Provider Demographics
NPI:1649222530
Name:CONSIGLIO, JOHN JAMES JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JAMES
Last Name:CONSIGLIO
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:3250 SW 133RD TER
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4612
Mailing Address - Country:US
Mailing Address - Phone:954-476-7007
Mailing Address - Fax:
Practice Address - Street 1:7369 SHERIDAN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-2776
Practice Address - Country:US
Practice Address - Phone:954-984-1668
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical