Provider Demographics
NPI:1851446025
Name:JOSEPH C MILITELLO MD PA
Entity Type:Organization
Organization Name:JOSEPH C MILITELLO MD PA
Other - Org Name:THE EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:MILITELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-683-4500
Mailing Address - Street 1:120 MEDICAL BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-0220
Mailing Address - Country:US
Mailing Address - Phone:352-683-4500
Mailing Address - Fax:352-683-2210
Practice Address - Street 1:120 MEDICAL BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-0220
Practice Address - Country:US
Practice Address - Phone:352-683-4500
Practice Address - Fax:352-683-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78744207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265881001Medicaid
FLP00197018OtherRAILROAD
FLK7068Medicare PIN
FL62712AMedicare ID - Type UnspecifiedMEDICARE
FLP00197018OtherRAILROAD