Individual provider Active NPI

Mario E Litano, M.D.

  • General Practice Physician
  • Bradenton, FL
National Provider Identifier
1841326345
Registry record updated Sep 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME90210 Issued in FL
Practice address
9908 Sr 64 East
Bradenton, FL 34212-5303
Phone
(941) 747-8600
Fax
(941) 749-5915
NPI assigned
Feb 26, 2007
Last updated
Sep 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME90210 FL Primary

Addresses

Primary practice location

9908 Sr 64 East
Bradenton, FL 34212-5303

Mailing address

367 S. Gulph Rd
Att: Ipm Credentialing
King of Prussia, PA 19406-3121
Phone (775) 356-9393

Other identifiers 1

IdentifierTypeStateIssuer
ME90210OtherFLSTATE LICENSE

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
I20081204000920 FL Practitioner - General PracticePractitioner - Emergency Medicine 2769543073

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME90210FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Plus Medical Center Inc CurrentSince May 17, 2011 Accepting new patients
Southern California Physician Network, Inc Past Accepting new patients

Locations

501 NW 179th Ave
Ste 101
Pembroke Pines, FL 33029
Phone (954) 442-2828

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506470400000",
    "number": "1841326345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S. GULPH RD",
            "address_2": "ATT: IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "775-356-9393",
            "fax_number": "775-356-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9908 SR 64 EAST",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342125303",
            "telephone_number": "941-747-8600",
            "fax_number": "941-749-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITANO",
        "first_name": "MARIO",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2017-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME90210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME90210",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.