Provider Demographics
NPI:1033141106
Name:GIOVANETTI, PENNY MARIE (DO)
Entity type:Individual
Prefix:
First Name:PENNY
Middle Name:MARIE
Last Name:GIOVANETTI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4881 NW 8TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4582
Mailing Address - Country:US
Mailing Address - Phone:352-373-6338
Mailing Address - Fax:352-371-6144
Practice Address - Street 1:3305 SW 34TH CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-6616
Practice Address - Country:US
Practice Address - Phone:352-732-4438
Practice Address - Fax:352-732-0028
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-05-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS1120208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEO808ZMedicare PIN