Provider Demographics
NPI:1700888724
Name:PIETRONIRO, ANTHONY G (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:G
Last Name:PIETRONIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4951 GRANDE DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8965
Mailing Address - Country:US
Mailing Address - Phone:850-473-0100
Mailing Address - Fax:850-473-0500
Practice Address - Street 1:9301 BEATRICE DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-5867
Practice Address - Country:US
Practice Address - Phone:850-476-7555
Practice Address - Fax:850-466-3777
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2025-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME59043208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL052579100Medicaid
FL052579100Medicaid