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Individual

RICHARD GIOVANNELLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
600 E DIXIE AVE, LEESBURG, FL 34748-5925
(352) 867-8898
(352) 732-6282
Mailing address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3001
(352) 401-1160
(352) 401-1262

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME45735
FL
208000000X
Pediatrics Physician
ME45735
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
023744500
FL
01
04245
BLUE CROSS BLUE SHIELD
FL
01
050085132
RAILROAD MEDICARE
FL
01
505428580
TRICARE
FL
Enumeration date
06/02/2006
Last updated
07/24/2020
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