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Individual

ROBERT A IANNACONE

Active
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Individual

ROBERT A IANNACONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM, P.A.

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO0002344
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1158590001
MEDICARE DME
—
05
—
390134300
—
FL
01
—
5400043
AETNA
—
01
—
6200153
GHI
—
01
—
65302
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/26/2005
Last updated
11/08/2023
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