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Provider Information for 1225055734

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. JOSEPH BORRELLI JR. MD

Gender: MALE

Individual NPI: 1225055734

Calendar   Last Updated:  2017-03-14
  Certification Date: 

Details

Name Value
NPI 1225055734
Enumeration Date 2006-07-17
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address PO BOX 10744
CLEARWATER, FL 33757-8744
United States

Phone: 727-532-0002 | Fax: 727-266-4943
View Map External Link
Primary Practice Address 4211 VAN DYKE RD SUITE 200
LUTZ, FL 33558-8005
United States

Phone: 813-264-6490 | Fax: 813-443-8143
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other MO-BLUE SHIELD 32649
MEDICAID TX 185708806
MEDICAID MO 208250407
MEDICAID TX 185708807
MEDICAID FL 019871600
Other BCBS TX 8FV255
Other RAIL ROAD MEDICARE TX P01658512
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207X00000X - Orthopaedic Surgery FL ME129953
No 207X00000X - Orthopaedic Surgery TX M6538