Basic Information
| Provider Information | |||||||||
| NPI: | 1336154608 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILIZIANO | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4296 | ||||||||
| Address2: | |||||||||
| City: | SACASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342304296 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278963134 | ||||||||
| FaxNumber: | 7278275155 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 PINELLAS STREET | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337563804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278963134 | ||||||||
| FaxNumber: | 7278275155 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2006 | ||||||||
| LastUpdateDate: | 07/11/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085N0904X | ME0065325 | FL | Y | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | 2085R0202X | ME0065325 | FL | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0203X | ME0065325 | FL | N | Allopathic & Osteopathic Physicians | Radiology | Therapeutic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 78692 | 01 | FL | BCBS | OTHER | 3805400 | 01 | UNITED HEALTH CARE | OTHER | 266473900 | 05 | FL | MEDICAID | P00030468 | 01 | MEDICARE RR | OTHER |