Provider Demographics
NPI:1982824520
Name:EMILIO ANTONETTI MD PA
Entity Type:Organization
Organization Name:EMILIO ANTONETTI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANTONETTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-202-1380
Mailing Address - Street 1:6160 N DAVIS HWY
Mailing Address - Street 2:SUITE 11
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-6994
Mailing Address - Country:US
Mailing Address - Phone:850-202-1380
Mailing Address - Fax:850-478-4927
Practice Address - Street 1:6160 N DAVIS HWY
Practice Address - Street 2:SUITE 11
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-6994
Practice Address - Country:US
Practice Address - Phone:850-202-1380
Practice Address - Fax:850-478-4927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty