Individual provider Active NPI

Robert A Fasoli, MD

  • Pulmonary Disease Physician
  • Bradenton, FL
National Provider Identifier
1790772770
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MEOO35792 Issued in FL
Practice address
2210 61St St W
Bradenton, FL 34209-5527
Phone
(941) 792-0611
Fax
(941) 792-0086
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MEOO35792 FL Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME0035792 FL

Addresses

Primary practice location

2210 61St St W
Bradenton, FL 34209-5527

Mailing address

2210 61St St W
Bradenton, FL 34209-5527
Phone (941) 792-0611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0035792FLMDCritical Care Medicine (Internal Medicine) Physician
MEOO35792FLMDPulmonary Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1790772770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 61ST ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095527",
            "telephone_number": "941-792-0611",
            "fax_number": "941-792-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 61ST ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095527",
            "telephone_number": "941-792-0611",
            "fax_number": "941-792-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASOLI",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "MEOO35792",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME0035792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; 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.