Individual
MARK ROBERT IANNOTTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
930 TAMIAMI TRL S, VENICE, FL 34285-3653
(941) 486-5444
(941) 486-5489
Mailing address
303 N HURSTBOURNE PKWY, STE 200, LOUISVILLE, KY 40222-5158
(941) 486-5444
(941) 486-5489
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT 21769
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y911K
BC/BS
FL
Enumeration date
05/18/2006
Last updated
04/04/2016
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