GINA PETRACCO PA NPI 1386196426

NPI Information

NPI: 1386196426
Provider Name: GINA PETRACCO, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: NAPLES CENTER FOR DERMATOLOGY AND RIVERCHASE DERMATOLOGY

PECOS Registration: Yes

Address:
25987 S TAMIAMI TRL STE 90
BONITA SPRINGS, FL
ZIP 34134
Phone: (239) 444-3201
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Gina Petracco, PA is a medical physician assistant in Bonita Springs, FL with 8 years of experience. Gina Petracco, PA NPI is 1386196426. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

25987 S TAMIAMI TRL STE 90
BONITA SPRINGS, FL
ZIP 34134-810
Phone: (239) 444-3201
Fax: (239) 992-9359

The NPI 1386196426 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/25/2016 and was last updated on 3/23/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA9109770	FLORIDA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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