Provider Demographics
NPI:1548488166
Name:GIANOLI, JOHN A III (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:GIANOLI
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6231 66TH STREET NORTH
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781
Mailing Address - Country:US
Mailing Address - Phone:727-544-3330
Mailing Address - Fax:727-544-3221
Practice Address - Street 1:6231 66TH ST
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-5025
Practice Address - Country:US
Practice Address - Phone:727-544-3330
Practice Address - Fax:727-544-3221
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86198208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME86198OtherSTATELICENSE
FLBG8856429OtherDEA