Individual
CHRISTOPHER ANTONELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HAS
Contact information
Practice address
1960 TAMIAMI TRL S, VENICE, FL 34293-5001
(941) 408-8077
Mailing address
1960 TAMIAMI TRL S, VENICE, FL 34293-5001
(941) 408-8077
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AS4961
FL
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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