Individual
DR. MARIO THELIARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2330 S CONGRESS AVE, WEST PALM BEACH, FL 33406-7608
(561) 432-5849
Mailing address
2330 S CONGRESS AVE, WEST PALM BEACH, FL 33406-7608
(561) 432-5849
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
020982
PR
208D00000X
General Practice Physician
Primary
ME140780
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010726500
—
FL
01
—
OS240
MEDICARE
FL
Enumeration date
07/31/2013
Last updated
08/13/2024
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