NPIMap

Organization Active NPI

Mariano D Cibran, MD Corp Dba St Petersburg Pediatrics

  • Pediatrics Physician
  • St Petersburg, FL
National Provider Identifier
1881260289
Registry record updated May 27, 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
4105 49TH St N
St Petersburg, FL 33709-5711
Phone
(727) 582-6900
NPI assigned
May 27, 2021
Last updated
May 27, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MARIANO D CIBRAN, MD CORP DBA ST PETERSBURG PEDIATRICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 27, 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 Physician 208000000X NU Primary

Addresses

Primary practice location

4105 49TH St N
St Petersburg, FL 33709-5711

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
373318107MedicaidFL

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.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1881260289",
    "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": "4105 49TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337095711",
            "telephone_number": "727-582-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIANO D CIBRAN, MD CORP DBA ST PETERSBURG PEDIATRICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARIANO D CIBRAN, MD CORP DBA ST PETERSBURG PEDIATRICS",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "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": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373318107",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.