Individual provider Active NPI

Mariel Carolina Rotundo-Patino, DO

  • Obstetrics & Gynecology Physician
  • Brandon, FL
National Provider Identifier
1780914135
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
OS11657 Issued in FL
Practice address
515 S Kings Ave Ste 1300
Brandon, FL 33511-6060
Phone
(813) 571-2777
Fax
(813) 571-2888
NPI assigned
Jan 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X OS11657 FL Primary

Addresses

Primary practice location

515 S Kings Ave Ste 1300
Brandon, FL 33511-6060

Mailing address

PO Box 748817
Atlanta, GA 30374-8817
Phone (813) 286-0033

Other practice location 1

815 S Parsons Ave
Brandon, FL 33511
Phone (813) 571-2777

Other practice location 2

13148 Vail Ridge Dr
Riverview, FL 33579-7187
Phone (813) 571-2777

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120717000249 FL Practitioner - Obstetrics/Gynecology 3870759046 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Care Florida LLCGroup PAC ID 9234031444, 324 clinicians

Practice addresses (Care Compare)

515 S Kings Ave
Suite 1300
Brandon, FL 33511-5921
Phone (813) 571-2777

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS11657FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Womens' Health Hospitalists, LLC Obstetrics & Gynecology CurrentSince Aug 29, 2018 Accepting new patients
Women'S Care Florida LLC Obstetrics & Gynecology CurrentSince Aug 29, 2018 Accepting new patients

Locations

515 S Kings Ave
Ste 1400
Brandon, FL 33511

515 S Kings Ave
Brandon, FL 33511
Phone (813) 681-9171

815 S Parsons Ave
Brandon, FL 33511
Phone (813) 571-2777

515 S Kings Ave
Ste 1300
Brandon, FL 33511
Phone (813) 571-2777

6606 Simmons Loop
Ste 150
Riverview, FL 33578

6606 Simmons Loop
Riverview, FL 33578
Phone (813) 574-1350

13148 Vail Ridge Dr
Riverview, FL 33579
Phone (813) 317-3930

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

5002 W Lemon St
Tampa, FL 33609

4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1780914135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748817",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748817",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S KINGS AVE STE 1300",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116060",
            "telephone_number": "813-571-2777",
            "fax_number": "813-571-2888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 S Parsons Ave",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "33511",
            "country_code": "US",
            "telephone_number": "813-571-2777",
            "fax_number": "813-571-2777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13148 Vail Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335797187",
            "country_code": "US",
            "telephone_number": "813-571-2777",
            "fax_number": "813-571-2888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTUNDO-PATINO",
        "first_name": "MARIEL",
        "middle_name": "CAROLINA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-07",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "OS11657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.