Provider Demographics
NPI:1780914135
Name:ROTUNDO-PATINO, MARIEL CAROLINA (DO)
Entity type:Individual
Prefix:
First Name:MARIEL
Middle Name:CAROLINA
Last Name:ROTUNDO-PATINO
Suffix:
Gender:F
Credentials:DO
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 748817
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8817
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:515 S KINGS AVE STE 1300
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6060
Practice Address - Country:US
Practice Address - Phone:813-571-2777
Practice Address - Fax:813-571-2888
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11657207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology