Michael C. Ianniello, DO
Internal Medicine in Melbourne, FL. Organization (NPI-2).
NPI number1407142425
StatusActive
Last updated in NPPESSep 26, 2019
Details
- NPI
- 1407142425
- Entity type
- Organization (NPI-2)
- Legal business name
- Michael C. Ianniello, DO
- Organization subpart
- No
- Enumeration date
- Jun 28, 2011
- Last updated
- Sep 26, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
2560 Judge Fran Jamieson Way Unit 1313Melbourne, FL 32940
Phone 954-235-3752
Mailing address
2560 Judge Fran Jamieson Way Unit 1313Melbourne, FL 32940-6199
Phone 954-235-3752
Other practice locations
5205 Babcock St Ne Ste 3
Palm Bay, FL 32905-4638
Palm Bay, FL 32905-4638
Phone 321-729-1400 · Fax 321-728-5700
Authorized official
Michael Ianniello
Owner, Physician
9542353752
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