Provider Demographics
NPI:1184824898
Name:CURATOLO, MARK A
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:A
Last Name:CURATOLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26027
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33320-6027
Mailing Address - Country:US
Mailing Address - Phone:954-752-3257
Mailing Address - Fax:954-752-3542
Practice Address - Street 1:4001 N OCEAN DR STE 304
Practice Address - Street 2:
Practice Address - City:LAUDERDALE BY THE SEA
Practice Address - State:FL
Practice Address - Zip Code:33308-5968
Practice Address - Country:US
Practice Address - Phone:954-752-3257
Practice Address - Fax:954-752-3542
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00539972471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLA64868Medicare UPIN
FLE1889Medicare PIN