# VINCENT EDWARD MORTELLARO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1972671287
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | TRN8848 | FL | — |
| 2086S0120X | Pediatric Surgery Physician | 30918 | AL | — |
| 2086S0120X | Pediatric Surgery Physician | ME179866 | FL | Yes |

## Other

- **Enumeration date:** 12/04/2006
- **Last updated:** 08/10/2026

## 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 |