Provider Demographics
NPI:1669463212
Name:MALLARINO, MARIA C (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:C
Last Name:MALLARINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1782 OAK ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-7537
Mailing Address - Country:US
Mailing Address - Phone:941-544-2371
Mailing Address - Fax:
Practice Address - Street 1:1782 OAK ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-7537
Practice Address - Country:US
Practice Address - Phone:941-544-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63160207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265673600Medicaid
FL25016ZMedicare PIN
FL265673600Medicaid
FLP00137403OtherRR MEDICARE