Individual
DR. PAUL MUCCIOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 S PENINSULA DR, DAYTONA BEACH, FL 32118-4422
(386) 310-2160
(386) 310-2106
Mailing address
222 S PENINSULA DR, DAYTONA BEACH, FL 32118-4422
(386) 310-2160
(386) 310-2106
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME0069281
FL
207Q00000X
Family Medicine Physician
ME0069281
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252127000
—
FL
Enumeration date
11/17/2006
Last updated
01/20/2025
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