Provider Demographics
NPI:1841714805
Name:VENICE PODIATRY PLLC
Entity type:Organization
Organization Name:VENICE PODIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GIANNONE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:941-412-3000
Mailing Address - Street 1:518 BAYSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:NOKOMIS
Mailing Address - State:FL
Mailing Address - Zip Code:34275-3439
Mailing Address - Country:US
Mailing Address - Phone:941-412-3000
Mailing Address - Fax:941-412-3005
Practice Address - Street 1:411 COMMERCIAL CT STE G
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1650
Practice Address - Country:US
Practice Address - Phone:941-412-3000
Practice Address - Fax:941-412-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty