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Individual

MARIO E PROFET

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD, RDMS, RDCS, RPVI

Contact information

Practice address
11017 N DALE MABRY HWY STE B, TAMPA, FL 33618-3873
(813) 337-7402
(813) 461-6462
Mailing address
11017 N DALE MABRY HWY STE B, TAMPA, FL 33618-3873
(133) 377-4028
(813) 461-6462

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
ACN304
FL
208D00000X
General Practice Physician
Primary
ME135981
FL
246XS1301X
Sonography Specialist/Technologist Cardiovascular
76083
2471S1302X
Sonography Radiologic Technologist
76083
2471V0105X
Vascular Sonography Radiologic Technologist
76083

Other

Enumeration date
02/08/2007
Last updated
10/24/2019
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