Active NPI
Joseph Gary Fortunato, DO
- Adult Medicine Physician
- Dade City, FL
National Provider Identifier
1851459309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- 18129
- Practice address
- 14027 5TH St
Dade City, FL 33525-4302 - Phone
- (352) 518-2000
- Fax
- (352) 567-5193
- NPI assigned
- Dec 5, 2006
- Last updated
- Mar 21, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | 18129 | CO | Primary |
Addresses
Primary practice location
14027 5TH St
Dade City, FL 33525-4302
Mailing address
PO Box 232
Dade City, FL 33526-0232
Phone (352) 518-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003355300 | Medicaid | FL |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18129 | CO | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332288000000",
"number": "1851459309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 232",
"city": "DADE CITY",
"state": "FL",
"postal_code": "335260232",
"telephone_number": "352-518-2000",
"fax_number": "352-567-5193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14027 5TH ST",
"city": "DADE CITY",
"state": "FL",
"postal_code": "335254302",
"telephone_number": "352-518-2000",
"fax_number": "352-567-5193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTUNATO",
"first_name": "JOSEPH",
"middle_name": "GARY",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2012-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "CO",
"license": "18129",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003355300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dade City, FL
- Florida Em-I Medical Services PA
- Florida Hospital Dade City Inc (AdventHealth Dade City)
- Florida Hospital Dade City Inc (AdventHealth Dade City TCU)
- Florida Medical Clinic LLC
- Florida Medical Clinic, LLC
- Monica Franceschini, APRN
- Franklin Pharmacy South LLC
- David W Friedman, D.D.S.
- Tracey Fulcher, RN
- China Valencia Gadsden, RBT, HHA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.