Provider Demographics
NPI:1891757902
Name:FORCONI, RION J (MD)
Entity Type:Individual
Prefix:
First Name:RION
Middle Name:J
Last Name:FORCONI
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 1:385 WAYMONT CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3574
Mailing Address - Country:US
Mailing Address - Phone:407-330-7546
Mailing Address - Fax:407-323-8286
Practice Address - Street 1:385 WAYMONT CT
Practice Address - Street 2:SUITE 101
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3574
Practice Address - Country:US
Practice Address - Phone:407-330-7546
Practice Address - Fax:407-323-8286
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0054135207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10328Medicare ID - Type UnspecifiedPROVIDER NUMBER
E49331Medicare UPIN
FL10328ZMedicare PIN