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Provider Information for 1760471502

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. VINCENT J DILELLA DO

Gender: MALE

Individual NPI: 1760471502

Calendar   Last Updated:  2014-12-02
  Certification Date: 

Details

Name Value
NPI 1760471502
Enumeration Date 2005-10-14
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 703 VIRGINIA ST
DUNEDIN, FL 34698-6615
United States

Phone: 727-734-4000 | Fax: 727-738-5037
View Map External Link
Primary Practice Address 703 VIRGINIA ST
DUNEDIN, FL 34698-6615
United States

Phone: 727-734-4000 | Fax: 727-738-5037
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other BCBS FL 80899
MEDICAID FL 372893500
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207Q00000X - Family Medicine FL OS0006347