Provider Demographics
NPI:1134153430
Name:D'AURIA, JOHN JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:D'AURIA
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 1:100 3RD AVE W
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8638
Mailing Address - Country:US
Mailing Address - Phone:941-708-9555
Mailing Address - Fax:941-708-5465
Practice Address - Street 1:100 3RD AVE W
Practice Address - Street 2:SUITE 110
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8638
Practice Address - Country:US
Practice Address - Phone:941-708-9555
Practice Address - Fax:941-708-9555
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51530207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6188109Medicaid
FL543-81299-1Medicaid
MAJ04148Medicare ID - Type Unspecified
FLFY32ZMedicare PIN
MAA57189Medicare UPIN
MA6188109Medicaid