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PPN Detailed Record





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TRICARE Europe Logo Preferred Provider Network (PPN) Banner TRICARE Europe Logo

PPN Detailed Record


Preferred Provider

Name: Prof.Dott. Duilio Siravo
Office Address: Corso Italia 178
Pisa, 56100 Italy
Office Tel: (39) 050-500653
Primary Speciality: Ophthalmology
MOU Expiration: 9/14/2011
MOU Number: 2649
Provider ID: ITA002585

Participating in Livorno MTF Network:

MTF Network Address: U.S. Army Health Clinic Livorno
CMR 426 Box 23
ATTN: CPT Gregory D. Iverson
APO AE 09613
Network Coordinator: Micaela Ballucchi
Commercial Tel: 0039-050-54-7883
DSN Tel: 633-7883

This Provider has signed a Memorandum of Understanding (MOU) with a U.S. military commander and agreed to welcome all U.S. Department of Defense beneficiaries and to provide them assistance with claims filing. The MOU also certifies that this provider has produced documents which support appropriate qualifications in accordance with the rules and laws of the host nation in which they practice.

If routine care has been pre-authorized or a proper referral has been issued, this provider will not require up front payment from TRICARE Prime Enrollees.

You are also advised that services not defined as TRICARE benefits are the responsibility of the patient.


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