NPIMap

Organization Active NPI

Mariano D Cibran, MD Corp Dba St Petersburg Pediatrics

  • Pediatrics Physician
  • Largo, FL
National Provider Identifier
1689249062
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MARIANO D CIBRAN, MD CORP DBA ST PETERSBURG PEDIATRICS
Practice address
3475 E Bay Dr
Largo, FL 33771-5905
Phone
(727) 535-9700
NPI assigned
May 26, 2021
Organization subpart
Yes
Parent organization
MARIANO CIBRAN, MD CORP DBA ST PETERSBURG PEDIATRICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Authorized official

Name
Kelly McPhail
Title
Administrator
Phone
(727) 526-9135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

3475 E Bay Dr
Largo, FL 33771-5905

Mailing address

2115 Central Ave
St Petersburg, FL 33713-8815
Phone (727) 526-9135

Other identifiers 1

IdentifierTypeStateIssuer
373318105MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Mariano D Cibran MD Corp Dba St Petersburg Pediatrics9 organizations share this tax ID, including this one
Part of
Mariano D Cibran MD Corp Dba St Petersburg Pediatrics

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621987200000",
    "number": "1689249062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138815",
            "telephone_number": "727-526-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 E BAY DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337715905",
            "telephone_number": "727-535-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIANO D CIBRAN, MD CORP DBA ST PETERSBURG PEDIATRICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARIANO CIBRAN, MD CORP DBA ST PETERSBURG PEDIATRICS",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A",
        "authorized_official_last_name": "MCPHAIL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "727-526-9135"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373318105",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.