Vincent P Fortunato MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R1J64 Issued in MO

Legal business name

VINCENT P FORTUNATO MD LLC

Practice address

10004 Kennerly Rd
255A
Saint Louis, MO 63128-2141

Phone

(314) 843-5140

Fax

(314) 843-8010

NPI assigned

Aug 17, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Vincent Fortunato, M.D.

Title

President

Phone

(314) 843-5140

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282003200000",
    "number": "1033424809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "255A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-843-5140",
            "fax_number": "314-843-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "255A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-843-5140",
            "fax_number": "314-843-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINCENT P FORTUNATO MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-17",
        "last_updated": "2010-08-17",
        "status": "A",
        "authorized_official_last_name": "FORTUNATO",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-843-5140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R1J64",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206760100",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claudia Regina Villatoro Santos, MD
• Maria Fernanda Villavicencio Jimenez, MD
• Alejandra Villescas, CRNA
• Courtney Villmer, MS
• Alberto Viloria, MD
• Vincent Riggio DDS LLC
• Vincent Sollecito,III
• Cyndra Vincent
• Joyce Diane Vincent
• Justin David Vincent, MD

• Internal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.