Individual
DR. KIRK DOMINIC CIANCIOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
12464 INDIAN ROCKS RD, LARGO, FL 33774
(727) 596-5446
(727) 593-0002
Mailing address
909 RIVIERA DUNES WAY, PALMETTO, FL 34221-7127
(727) 798-2299
(727) 593-0002
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
03552
KY
208800000X
Urology Physician
Primary
OS0004645
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017137800
—
FL
01
—
211521
AVMED
FL
01
—
3972115
CIGNA
FL
01
—
JTNOA
BCBS
FL
Enumeration date
08/30/2012
Last updated
11/08/2019
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