Mario Noel Favilli, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0050696 Issued in FL

Practice address

4855 W Hillsboro Blvd
B8
Coconut Creek, FL 33073-4356

Phone

(954) 481-2278

Fax

(954) 481-1987

NPI assigned

Apr 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1730304221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 W HILLSBORO BLVD",
            "address_2": "SUITE B8",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734356",
            "telephone_number": "954-481-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 W HILLSBORO BLVD",
            "address_2": "B8",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734356",
            "telephone_number": "954-481-2278",
            "fax_number": "954-481-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVILLI",
        "first_name": "MARIO",
        "middle_name": "NOEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0050696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Smiles of Coconut Creek, PLLC
• Marie Betty Fanfan, RN
• Jeanan Fares
• Tammye Farmer, R.D.
• Farr Dental
• Fede Sports and Physical Therapy LLC
• Stacie Lynn Feise, RN
• Ali Feldman-Butters, LMHC
• Alisa Lee Feldman, AU.D
• Dawn Fele, MS, CCC/SLP

• Family Medicine Physician in Coconut Creek, FL
• Providers in Coconut Creek, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.