Provider Demographics
NPI:1649258864
Name:TRONETTI, PAMELA S (DO)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:S
Last Name:TRONETTI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 CENTURY MEDICAL DR STE C
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2100
Mailing Address - Country:US
Mailing Address - Phone:321-268-6264
Mailing Address - Fax:321-385-1118
Practice Address - Street 1:805 CENTURY MEDICAL DR STE A
Practice Address - Street 2:PARRISH MEDICAL GROUP
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2100
Practice Address - Country:US
Practice Address - Phone:321-383-9393
Practice Address - Fax:321-385-1118
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9777207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275222100Medicaid
FLU7750ZMedicare PIN
FL275222100Medicaid