Individual
MARY SANICOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(888) 663-3488
Mailing address
PO BOX 198441, ATLANTA, GA 30384-8441
(813) 745-7365
(813) 449-8618
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
AA366
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019139200
—
FL
Enumeration date
09/06/2016
Last updated
02/25/2025
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