Cucchiarella, Mario

Cucchiarella, Mario is an individual health care provider with primary practice located at 740 Dunlawton Ave Ste. 200, Port Orange FL 32127-4239. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Cucchiarella, Mario can be contacted via phone (386) 763-1000.

Contact Information

Primary practice address
740 Dunlawton Ave Ste. 200 Port Orange FL 32127-4239
Phone: (386) 763-1000
Fax: (386) 763-0507
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME0047726 Florida

Profile Details

NPI number 1790756765
LBN Legal business name Cucchiarella, Mario
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Jun 11th, 2014 - about 11 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 1790756765 NPPES
Florida MEDICAID 267212000
Florida Other 1790756765
Florida Other 14596
Florida Other ME0047726

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