Carbonell, Mario E

Carbonell, Mario E is an sole proprietor health care provider with primary practice located at 17912 Toledo Blade Blvd Ste A , Port Charlotte FL 33948-1042. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Carbonell, Mario E can be contacted via phone (941) 766-1001.

Contact Information

Primary practice address
17912 Toledo Blade Blvd Ste A Port Charlotte FL 33948-1042
Phone: (941) 766-1001
Fax: (941) 766-1830
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME0065067 Florida

Profile Details

NPI number 1639150048
LBN Legal business name Carbonell, Mario E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 11th, 2005
Last updated May 18th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639150048 NPPES
Florida MEDICAID 375926100

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