Provider Demographics
NPI:1285677070
Name:CONOL, MARIO C JR (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIO
Middle Name:C
Last Name:CONOL
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:13022 MILFORD PL
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8454
Mailing Address - Country:US
Mailing Address - Phone:239-898-2187
Mailing Address - Fax:239-309-0642
Practice Address - Street 1:13022 MILFORD PL
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8454
Practice Address - Country:US
Practice Address - Phone:239-898-2187
Practice Address - Fax:239-309-0642
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2024-02-01
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Provider Licenses
StateLicense IDTaxonomies
FLME87158207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL41728OtherBLUE CROSS BLUE SHIELD OF FL
FL41728OtherBLUE CROSS BLUE SHIELD OF FL