| Giovanni Lupo, Inc | |
|
1032 Fieldstone Dr Melbourne FL 32940-1633 | |
| (321) 435-3500 | |
| (321) 752-4489 |
| Full Name | Giovanni Lupo, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1032 Fieldstone Dr, Melbourne, Florida |
| Authorized Official Name and Position | Giovanni Lupo (OWNER) |
| Authorized Official Contact | 3212596478 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Giovanni Lupo, Inc 1032 Fieldstone Dr Melbourne FL 32940-1633 Ph: (321) 435-3500 | Giovanni Lupo, Inc 1032 Fieldstone Dr Melbourne FL 32940-1633 Ph: (321) 435-3500 |
| NPI Number | 1497158125 |
|---|---|
| Provider Enumeration Date | 10/08/2014 |
| Last Update Date | 10/08/2014 |
| Medicare PECOS PAC ID | 7113240672 |
|---|---|
| Medicare Enrollment ID | O20150108001408 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497158125 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | ME76857 (Florida) | Primary |
| Provider Name | Giovanni Lupo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255394060 PECOS PAC ID: 0143116558 Enrollment ID: I20070703000139 |
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