Doctor Name: | MARIO E LITANO |
NPI Number: | 1841326345 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME90210 |
Business Practice Address: | 9908 Sr 64 East Bradenton, FL - 342125303 |
Business Phone Number: | 9417478600 |
Business Fax Number: | 9417495915 |
Mailing Address: | Po Box 637801, Att: Ipm Credentialing CINCINNATI |
State: | OH |
Postal Code: | 452637801 |
Phone Number: | 7753569393 |
Fax Number: | 7753565590 |
NPI Enumeration Date: | 02/26/2007 |
NPI Last Update Date: | 04/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME90210 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |