Individual
MARIO E LITANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9908 SR 64 EAST, BRADENTON, FL 34212-5303
(941) 747-8600
(941) 749-5915
Mailing address
367 S. GULPH RD, ATT: IPM CREDENTIALING, KING OF PRUSSIA, PA 19406-3121
(775) 356-9393
(775) 356-5590
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME90210
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME90210
STATE LICENSE
FL
Enumeration date
02/26/2007
Last updated
09/27/2017
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