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Individual
VINCENT EDWARD MORTELLARO
Active
Individual
VINCENT EDWARD MORTELLARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
TRN8848
FL
2086S0120X
Pediatric Surgery Physician
30918
AL
2086S0120X
Pediatric Surgery Physician
Primary
ME179866
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01356513
—
MS
01
—
051117802
BCBS
AL
01
—
051117803
BCBS
AL
01
—
051117804
BCBS
AL
01
—
051117806
BCBS
AL
05
—
129871
—
AL
05
—
129872
—
AL
05
—
129873
—
AL
05
—
129875
—
AL
Enumeration date
12/04/2006
Last updated
08/10/2026
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