Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | ME98420 | FL |
NPI | 1235210725 |
---|---|
Provider Name | Dr. Philip Patrick Mularoni |
First Address | St Petersburg, FL 33701 |
Second Address | St Petersburg, FL 33701-4634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 10/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
447966759 | (05) | GA |