Provider Demographics
NPI:1144303009
Name:MINNI, JOHN PAUL (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:MINNI
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1400 SE GOLDTREE DRIVE
Mailing Address - Street 2:SUITE A-7
Mailing Address - City:PORT ST. LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952
Mailing Address - Country:US
Mailing Address - Phone:772-335-3550
Mailing Address - Fax:772-237-8013
Practice Address - Street 1:2601 S KANNER HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4622
Practice Address - Country:US
Practice Address - Phone:772-219-2777
Practice Address - Fax:772-219-0017
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2021-01-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS8747207Q00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine