Individual
DR. MARY ANN VACCARELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
927 45TH ST STE 206, MANGONIA PARK, FL 33407-2450
(561) 844-8354
Mailing address
5955 PONCE DE LEON BLVD, CORAL GABLES, FL 33146-2423
(305) 611-1515
(305) 662-3723
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
ME 0056044
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379171800
—
FL
01
—
ME 0056044
MEDICAL LICENSE NUMBER
FL
Enumeration date
01/24/2007
Last updated
06/24/2019
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