Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 51994 | MN |
Y | 2080P0202X | Pediatric Cardiologist | ME120031 | FL |
NPI | 1073769048 |
---|---|
Provider Name | Daniel Anthony Mauriello |
First Address | St Petersburg, FL 33701-4804 |
Second Address | St Petersburg, FL 33701-4804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2008 |
Last Update Date | 19/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
012021900 | (05) | FL |