Basic Information
| Provider Information | |||||||||
| NPI: | 1437157773 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARRITANO | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | PASCAL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 502 LOOKOUT CT | ||||||||
| Address2: | |||||||||
| City: | LARGO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337702726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275843414 | ||||||||
| FaxNumber: | 7275843414 | ||||||||
| Practice Location | |||||||||
| Address1: | VETERANS AFFAIRS MEDICAL CENTER | ||||||||
| Address2: | 10000 BAY PINES BLVD | ||||||||
| City: | ST. PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273986661 | ||||||||
| FaxNumber: | 7273989575 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | ME17959 | FL | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 71269 | 01 | FL | BLUE CROSS BLUE SHEILD | OTHER |