Provider Demographics
NPI:1184719080
Name:LOBEL, DARLENE A (MD)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:A
Last Name:LOBEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DARLENE
Other - Middle Name:A
Other - Last Name:MAYO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 3RD AVE W STE 200
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8633
Mailing Address - Country:US
Mailing Address - Phone:941-794-3118
Mailing Address - Fax:941-782-2017
Practice Address - Street 1:200 3RD AVE W STE 200
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8633
Practice Address - Country:US
Practice Address - Phone:941-794-3118
Practice Address - Fax:941-782-2017
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95249207T00000X
GA053066207T00000X
MN56369207T00000X
VA0101253899207T00000X
FLME99279207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL119058200Medicaid
FL2785587-00Medicaid
FLP00654525Medicare PIN
FL2785587-00Medicaid