Provider Demographics
NPI:1336154608
Name:MILIZIANO, JOHN S (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:S
Last Name:MILIZIANO
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:PO BOX 4296
Mailing Address - Street 2:
Mailing Address - City:SACASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34230-4296
Mailing Address - Country:US
Mailing Address - Phone:727-896-3134
Mailing Address - Fax:727-827-5155
Practice Address - Street 1:300 PINELLAS STREET
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3804
Practice Address - Country:US
Practice Address - Phone:727-896-3134
Practice Address - Fax:727-827-5155
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00653252085N0904X, 2085R0202X, 2085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL78692OtherBCBS
3805400OtherUNITED HEALTH CARE
FL266473900Medicaid
P00030468OtherMEDICARE RR
3805400OtherUNITED HEALTH CARE
FL266473900Medicaid