Provider Demographics
NPI:1396749131
Name:CAPONE, EDWARD A (DO)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:A
Last Name:CAPONE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:11528 US HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-1442
Mailing Address - Country:US
Mailing Address - Phone:727-868-2151
Mailing Address - Fax:727-868-8251
Practice Address - Street 1:11528 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-1442
Practice Address - Country:US
Practice Address - Phone:727-868-2151
Practice Address - Fax:727-868-7379
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2009-11-30
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Provider Licenses
StateLicense IDTaxonomies
FLOS0003776207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262621OtherAVMED
FL01372OtherUNIVERSAL
FL059405900Medicaid
FL01-05310OtherUNITED HEALTH CARE
FL080074039OtherRAILROAD MEDICARE
FL11151702OtherCITRUS GCMC2
FL2151031OtherAETNA HMO
FL82146OtherBLUE CROSS BLUE SHIELD OF FLORIDA
FL4658471OtherAETNA PPO
FL11151701OtherCITRUS GCMC 1
FL6100347OtherGHI
FL6100347OtherGHI
FL080074039OtherRAILROAD MEDICARE