NPIMap

Organization Active NPI

Mariner Primecare Medical Center LLC

  • General Practice Physician
  • Spring Hill, FL
National Provider Identifier
1316192867
Registry record updated Nov 25, 2008
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Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME83175 Issued in FL
Legal business name
MARINER PRIMECARE MEDICAL CENTER LLC
Practice address
7056 Mariner Blvd
Spring Hill, FL 34609-1000
Phone
(352) 597-5557
Fax
(352) 597-0552
NPI assigned
Nov 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2008

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

Authorized official

Name
Mr. Martin Revello, MPH
Title
President
Phone
(813) 514-6750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X ME83175 FL Primary

Addresses

Primary practice location

7056 Mariner Blvd
Spring Hill, FL 34609-1000

Mailing address

7056 Mariner Blvd
Spring Hill, FL 34609-1000
Phone (352) 597-5557

National Provider Directory

National Provider Directory

Locations

7056 Mariner Blvd
Spring Hill, FL 34609
Phone (352) 597-5557

NPI Registry JSON

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227571200000",
    "number": "1316192867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7056 MARINER BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346091000",
            "telephone_number": "352-597-5557",
            "fax_number": "352-597-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7056 MARINER BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346091000",
            "telephone_number": "352-597-5557",
            "fax_number": "352-597-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINER PRIMECARE MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-25",
        "last_updated": "2008-11-25",
        "status": "A",
        "authorized_official_last_name": "REVELLO",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-514-6750",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME83175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Hill, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.