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Organization
MARIO E CARBONELL MD PA
Active
Organization
MARIO E CARBONELL MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO E CARBONELL MD PA (OWNER)
(941) 766-1001
Entity
Organization
Contact information
Practice address
17912 TOLDEO BLADE BLVD STE A, PORT CHARLOTTE, FL 33948-1042
(941) 766-1001
(941) 766-1830
Mailing address
17912 TOLDEO BLADE BLVD STE A, PORT CHARLOTTE, FL 33948-1042
(941) 766-1001
(941) 766-1830
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0065067
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
375926100
—
FL
Enumeration date
09/23/2008
Last updated
11/12/2013
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