Provider Demographics
NPI:1386620631
Name:IACOBELLIS, FRANCIS W (MD)
Entity type:Individual
Prefix:
First Name:FRANCIS
Middle Name:W
Last Name:IACOBELLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:151 SOUTHHALL LN STE 300
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7172
Mailing Address - Country:US
Mailing Address - Phone:407-875-2080
Mailing Address - Fax:076-503-4554
Practice Address - Street 1:125 E 63RD ST UNIT 1BC
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7302
Practice Address - Country:US
Practice Address - Phone:212-661-3376
Practice Address - Fax:212-661-3366
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114091-1207N00000X
FLME132341207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133884168OtherHORIZON HEALTHCARE OF NY
NY2132222OtherAETNA HMO
NY4220508OtherAETNA NON HMO
NY133884168OtherEMPIRE STATE PLAN (NYS)
NY3C1366OtherHEALTHNET
NY133884168OtherBEECH STREET
NY13U231OtherBLUE CROSS HMO
NYP942741OtherOXFORD
NY133884168OtherMULTIPLAN
NY0250055Medicaid
NY114019OtherCONNECTICARE
NY317283OtherBLUE CROSS PPO
NY000000045835OtherGHI HMO
NY696790OtherPHCS
NY133884168OtherPOMCO
NY070011868OtherRAILROAD MEDICARE
NY133884168OtherUNITED HEALTH CARE
NY173187POtherHIP
NY133884168OtherPOMCO
NY317281Medicare ID - Type Unspecified