Provider Demographics
NPI:1659578938
Name:PAUL F FOTI, MD, FCCP, PA
Entity Type:Organization
Organization Name:PAUL F FOTI, MD, FCCP, PA
Other - Org Name:PAUL F FOTI, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:FOTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-347-5242
Mailing Address - Street 1:PO BOX 66405
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33736-6405
Mailing Address - Country:US
Mailing Address - Phone:727-347-5242
Mailing Address - Fax:727-347-2402
Practice Address - Street 1:1615 PASADENA AVE S
Practice Address - Street 2:SUITE 480
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-4516
Practice Address - Country:US
Practice Address - Phone:727-347-5242
Practice Address - Fax:727-347-2402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61531174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14928OtherBLUECROSS AND BLUESHIELD
FL14928OtherBLUECROSS AND BLUESHIELD
FL14928AMedicare ID - Type UnspecifiedMEDICARE #