Provider Demographics
NPI:1952383564
Name:RANIOLO, JOHN SALVATORE (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SALVATORE
Last Name:RANIOLO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5608
Mailing Address - Street 2:
Mailing Address - City:CAREFREE
Mailing Address - State:AZ
Mailing Address - Zip Code:85377-5608
Mailing Address - Country:US
Mailing Address - Phone:623-879-6000
Mailing Address - Fax:623-516-2000
Practice Address - Street 1:20414 N 27TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-3250
Practice Address - Country:US
Practice Address - Phone:623-879-6000
Practice Address - Fax:623-516-2000
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1968207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ232942Medicaid
AZ69513Medicare ID - Type Unspecified