Vincent P Fortunato MD LLC
Internal Medicine in Saint Louis, MO. Organization (NPI-2).
NPI number1033424809
StatusActive
Last updated in NPPESAug 17, 2010
Details
- NPI
- 1033424809
- Entity type
- Organization (NPI-2)
- Legal business name
- Vincent P Fortunato MD LLC
- Organization subpart
- No
- Enumeration date
- Aug 17, 2010
- Last updated
- Aug 17, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | R1J64 | MO | Yes |
Practice location
10004 Kennerly Rd255a
Saint Louis, MO 63128-2141
Phone 314-843-5140 · Fax 314-843-8010
Mailing address
10004 Kennerly Rd255a
Saint Louis, MO 63128-2141
Phone 314-843-5140 · Fax 314-843-8010
Authorized official
Vincent Fortunato
President
3148435140
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