Provider Demographics
NPI:1720037054
Name:SAGLIOCCA, GENNARO (MD)
Entity Type:Individual
Prefix:DR
First Name:GENNARO
Middle Name:
Last Name:SAGLIOCCA
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 1:2000 CONTINENTAL DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3207
Mailing Address - Country:US
Mailing Address - Phone:561-845-2680
Mailing Address - Fax:561-845-2637
Practice Address - Street 1:2000 CONTINENTAL DR
Practice Address - Street 2:SUITE B
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3207
Practice Address - Country:US
Practice Address - Phone:561-845-2680
Practice Address - Fax:561-845-2637
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053712207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE61640Medicare UPIN
FL10545Medicare PIN