1730879354 NPI number — PAUL CAPOBIANCO, DO, P.A.

Table of content: (NPI 1730879354)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730879354 NPI number — PAUL CAPOBIANCO, DO, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAUL CAPOBIANCO, DO, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730879354
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1820 NE JENSEN BEACH BLVD # 512
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JENSEN BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34957-7212
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-435-5260
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 STATE ST
Provider Second Line Business Practice Location Address:
26TH FL
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-435-5260
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/08/2023

Additional Information

Authorized Official

Authorized Official Last Name:
CAPOBIANCO
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
516-435-5260

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 204D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com