Provider Demographics
NPI:1013121706
Name:GIANNOTTI, PAUL A (ATC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:A
Last Name:GIANNOTTI
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1572 LAWNDALE CIR
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-6187
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 HOLT AVE
Practice Address - Street 2:BOX 2730
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4499
Practice Address - Country:US
Practice Address - Phone:407-646-2635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL15092255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer