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Individual
DR. MARIO THELIARD
Active
Individual
DR. MARIO THELIARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
020982
PR
208D00000X
General Practice Physician
Primary
ME140780
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010726500
—
FL
01
—
OS240
MEDICARE
FL
Enumeration date
07/31/2013
Last updated
08/13/2024
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