Mario E Carbonell MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0065067 Issued in FL

Legal business name

MARIO E CARBONELL MD PA

Practice address

17912 Toldeo Blade Blvd Ste a
Port Charlotte, FL 33948-1042

Phone

(941) 766-1001

Fax

(941) 766-1830

NPI assigned

Sep 23, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mario E Carbonell, MD PANPI 1639150048

Title

Owner

Phone

(941) 766-1001

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mario E Carbonell, MD

  • Internal Medicine Physician
  • Port Charlotte, FL
  • NPI 1639150048

  FL, Internal Medicine

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384214400000",
    "number": "1083864474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17912 TOLDEO BLADE BLVD STE A",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481042",
            "telephone_number": "941-766-1001",
            "fax_number": "941-766-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17912 TOLDEO BLADE BLVD STE A",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481042",
            "telephone_number": "941-766-1001",
            "fax_number": "941-766-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIO E CARBONELL MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2013-11-12",
        "status": "A",
        "authorized_official_last_name": "CARBONELL",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-766-1001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0065067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375926100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Micah Owen Marazon, D.P.T.
• Marc a. Melser, MD, PL
• Glenn J Marcus, D.O.
• Margaret G. Mayo, M.D. PA
• Nicole Marihart, PHARMD
• Mark E Gonwa MD PLLC Team Radiology
• Mark O. Asperilla M.D.P.a.
• Mark S. Tracy, D.P.M., P.a.
• Rayna Markle
• Luis Gerardo Marmol, M.D.

• All providers in Port Charlotte, FL
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.