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Organization

MARIANO D CIBRAN, MD CORP DBA ST PETERSBURG PEDIATRICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIANO D CIBRAN MD (PRESIDENT)
(727) 526-9135
Entity
Organization

Contact information

Practice address
2115 CENTRAL AVE, ST PETERSBURG, FL 33713-8815
(727) 526-9135
(727) 526-4346
Mailing address
2115 CENTRAL AVE, ST PETERSBURG, FL 33713-8815
(727) 526-9135
(727) 526-4346

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME27935
FL
363LP0200X
Pediatric Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
33499
BLUE CROSS BLUE SHIELD
FL
05
373318100
FL
05
373318101
FL
05
373318102
FL
05
373318103
FL
05
373318104
FL
05
373318105
FL
05
373318106
FL
05
373318107
FL
05
373318108
FL
Enumeration date
11/01/2006
Last updated
09/15/2021
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