Provider Demographics
NPI:1841558137
Name:31ST MEDGRP-AVIANO
Entity type:Organization
Organization Name:31ST MEDGRP-AVIANO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OIC RESOURCE MANAGEMENT OFFICE
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DINOFRIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-536-6650
Mailing Address - Street 1:PSC 6180 BOX 245
Mailing Address - Street 2:MSA OFFICE
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09603-0245
Mailing Address - Country:US
Mailing Address - Phone:01139043-430-5518
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 121 AVIANO AFB ITALY
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09604-0245
Practice Address - Country:US
Practice Address - Phone:01139043-430-5518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:31ST MEDGRP-AVIANO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-25
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital