Provider Demographics
NPI:1285931386
Name:CIOCCA DERMATOLOGY PA
Entity type:Organization
Organization Name:CIOCCA DERMATOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GIOVANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CIOCCA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-273-7998
Mailing Address - Street 1:7001 SW 97TH AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1406
Mailing Address - Country:US
Mailing Address - Phone:305-273-7998
Mailing Address - Fax:305-273-7275
Practice Address - Street 1:7001 SW 97TH AVE
Practice Address - Street 2:STE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1406
Practice Address - Country:US
Practice Address - Phone:305-273-7998
Practice Address - Fax:305-273-7275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-25
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95594207N00000X
208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME95594OtherFLORIDA MEDICAL LICENSE