Individual
DR. MILO BASTIANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
13660 S JOG RD STE 3, DELRAY BEACH, FL 33446-3806
(561) 495-2002
(561) 733-3742
Mailing address
13660 S JOG RD STE 3, DELRAY BEACH, FL 33446-3806
(561) 495-2002
(561) 733-3742
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
25MB06532600
NJ
207YS0123X
Facial Plastic Surgery Physician
25MB06532600
NJ
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
25MB06532600
NJ
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
OS16264
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
854041
AETNA
NJ
01
—
OS162264
LICENSE
FL
Enumeration date
06/07/2006
Last updated
02/17/2021
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