Provider Demographics
NPI:1669508883
Name:TRIOLA, BRIAN RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:RICHARD
Last Name:TRIOLA
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:PO BOX 495156
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33949-5156
Mailing Address - Country:US
Mailing Address - Phone:941-875-9533
Mailing Address - Fax:
Practice Address - Street 1:2300 LOVELAND BLVD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33980-5716
Practice Address - Country:US
Practice Address - Phone:941-629-4500
Practice Address - Fax:941-629-4171
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME104787207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL02269500Medicaid