Agostinelli, Joseph R

Agostinelli, Joseph R is an sole proprietor health care provider with primary practice located at 1034 Mar Walt Dr Ste 100 , Fort Walton Beach FL 32547-6645. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Agostinelli, Joseph R can be contacted via phone (850) 863-2153.

Contact Information

Primary practice address
1034 Mar Walt Dr Ste 100 Fort Walton Beach FL 32547-6645
Phone: (850) 863-2153
Fax: (850) 315-9350
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO2643 Florida

Profile Details

NPI number 1932103397
LBN Legal business name Agostinelli, Joseph R
Credentials DPM PA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 13th, 2005
Last updated Feb 15th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932103397 NPPES
Florida MEDICAID 340506100

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