Active NPI
Mark Mariani, PA-C
- Physician Assistant
- Fort Lauderdale, FL
National Provider Identifier
1174978357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 9109400
- Practice address
- 1820 E Commercial Blvd
Fort Lauderdale, FL 33308-3725 - Phone
- (954) 368-3430
- NPI assigned
- Apr 26, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 9109400 | FL | Primary |
Addresses
Primary practice location
1820 E Commercial Blvd
Fort Lauderdale, FL 33308-3725
Mailing address
1508 SW 22ND St
Fort Lauderdale, FL 33315-1835
Phone (954) 232-0501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 9109400 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462147200000",
"number": "1174978357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1508 SW 22ND ST",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333151835",
"telephone_number": "954-232-0501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1820 E COMMERCIAL BLVD",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333083725",
"telephone_number": "954-368-3430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIANI",
"first_name": "MARK",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-26",
"last_updated": "2016-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA 9109400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.