Provider Demographics
NPI:1649262882
Name:PULEO, JOHN ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANDREW
Last Name:PULEO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3900 CLARK RD STE B3
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-2369
Mailing Address - Country:US
Mailing Address - Phone:941-379-0088
Mailing Address - Fax:941-379-0010
Practice Address - Street 1:3900 CLARK RD STE B3
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2369
Practice Address - Country:US
Practice Address - Phone:941-379-0088
Practice Address - Fax:941-379-0010
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME70023207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379868200Medicaid
FL31251OtherBCBS
FLP00456702OtherRAIL ROAD MEDICARE
FL060068632OtherMEDICARE RR
FL379868200Medicaid
FL060068632OtherMEDICARE RR
FL31251VMedicare PIN