Mario E Profet, MD, RDMS, RDCS, RPVI

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME135981 Issued in FL

Practice address

11017 N Dale Mabry Hwy Ste B
Tampa, FL 33618-3873

Phone

(813) 337-7402

Fax

(813) 461-6462

NPI assigned

Feb 8, 2007

Sex

Male

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aarna Hospitality LLC

  • Community/Retail Pharmacy
  • Tampa, FL
  • NPI 1326422189
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mprofet@dphawcl-fl.direct.office.nextgen.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 24, 2019.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1487795092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11017 N DALE MABRY HWY STE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336183873",
            "telephone_number": "133-377-4028",
            "fax_number": "813-461-6462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11017 N DALE MABRY HWY STE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336183873",
            "telephone_number": "813-337-7402",
            "fax_number": "813-461-6462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFET",
        "first_name": "MARIO",
        "middle_name": "E",
        "credential": "MD, RDMS, RDCS, RPVI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN304",
            "primary": false
        },
        {
            "code": "246XS1301X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist Cardiovascular, Sonography",
            "state": null,
            "license": "76083",
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": null,
            "license": "76083",
            "primary": false
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": null,
            "license": "76083",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME135981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Professional Portable Radiologic Services Inc.
• Professional Portable Radiologic Services Inc.
• Professional Portable Radiologic Services Inc.
• Professional Psychiatric Associates
• Professional Urgent Care Services
• Daniele Profilo, M.S.
• Proformance Sports LLC
• Progress and Change Therapy LLC
• Progressive Family Care LLC
• Progressive Medical Group PA

• All providers in Tampa, FL
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.