Provider Demographics
NPI:1285878397
Name:POGGIO, ERINI VASILIADIS (DO)
Entity type:Individual
Prefix:DR
First Name:ERINI
Middle Name:VASILIADIS
Last Name:POGGIO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ERINI
Other - Middle Name:
Other - Last Name:VASILIADIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:7305 N MILITARY TRL
Mailing Address - Street 2:RM 1A-301
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-7417
Mailing Address - Country:US
Mailing Address - Phone:561-422-6650
Mailing Address - Fax:
Practice Address - Street 1:7305 N MILITARY TRL
Practice Address - Street 2:RM 1A-301
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-7417
Practice Address - Country:US
Practice Address - Phone:561-422-6650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013968207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine