Individual
MARIO JACOMINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
777 GLADES RD # BC-71, BOCA RATON, FL 33431-6496
(561) 297-0723
Mailing address
182 CITRUS TRAIL CIR, BOYNTON BEACH, FL 33436-1829
(561) 733-2846
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0063760
FL
2083P0901X
Public Health & General Preventive Medicine Physician
ME0063760
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3791033-00
—
FL
Enumeration date
07/02/2006
Last updated
01/31/2022
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