Provider Demographics
NPI:1689070906
Name:VULCANO, ETTORE (MD)
Entity Type:Individual
Prefix:DR
First Name:ETTORE
Middle Name:
Last Name:VULCANO
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 1:4302 ALTON RD STE 220
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2818
Mailing Address - Country:US
Mailing Address - Phone:305-674-2090
Mailing Address - Fax:305-674-2093
Practice Address - Street 1:4302 ALTON RD STE 220
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2818
Practice Address - Country:US
Practice Address - Phone:305-674-2090
Practice Address - Fax:305-674-2093
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
FLME147366207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No174400000XOther Service ProvidersSpecialist