Provider Demographics
NPI:1811962855
Name:SCOTTO D'ANTUONO, VINCENZO (MD)
Entity type:Individual
Prefix:
First Name:VINCENZO
Middle Name:
Last Name:SCOTTO D'ANTUONO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1000 DEPT 394
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:941-300-4440
Mailing Address - Fax:941-404-1760
Practice Address - Street 1:1301 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-7133
Practice Address - Country:US
Practice Address - Phone:407-246-1946
Practice Address - Fax:855-895-5749
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME144729207RI0200X
DEC-1-0006919207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMB959OtherFL MEDICARE
FL105879800Medicaid
FLMB959OtherFL MEDICARE
DEG43263OtherMEDICARE UPIN