DR. MARIO THELIARD (NPI# 1669804720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669804720 |
| Entity Type | Individual |
| Full Name | DR. MARIO THELIARD |
| Credential | M.D. |
| Practice Address |
3810 S Florida Ave Lakeland FL 33813-1105 |
| Mailing Address |
4094 Lake Ned Village Cir Winter Haven FL 33884-2587 |
| Practice Telephone | 8638588000 |
| Mailing Telephone | 5612154914 |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2014-02-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 020982 | PR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 1669804720 | 05 | |
| FL | MARIO71 | 05 |
| Street Address |
3810 S FLORIDA AVE |
| City | LAKELAND |
| State | FL |
| Zip Code | 33813-1105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225134745 | Esther Echevarria | General Practice | 3810 S Florida Ave, Lakeland, FL 33813-1105 | 2006-09-15 |
| 1588192082 | Subha Jose | Nurse Practitioner | 3810 S Florida Ave, Lakeland, FL 33813-1105 | 2017-05-26 |
| 1750821344 | Cynthia I Diaz Pineiro | Nurse Practitioner | 3810 S Florida Ave, Lakeland, FL 33813-1105 | 2017-03-01 |
| 1205236080 | Doctor Today Ipa,llc | Health Maintenance Organization | 3810 S Florida Ave, Lakeland, FL 33813-1105 | 2014-08-28 |
| 1053584144 | Flynn Clinic, Inc | Clinic/Center | 3810 S Florida Ave, Lakeland, FL 33813-1105 | 2008-04-09 |
| 1316081318 | Rekha Issar | Internal Medicine | 3810 S Florida Ave, Suir # A1, Lakeland, FL 33813-1105 | 2007-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427600030 | Genesis Vieyra Lopez | Nurse Practitioner | 631 Mid Florida Drive, Lakeland, FL 33813 | 2019-07-13 |
| 1306323340 | Sandrene Smart | Clinic/Center | 625 Commerce Dr. (suite 103), Lakeland, FL 33813 | 2018-07-23 |
| 1033560586 | Charles D. Llano, D.d.s. | Dentist | 320 West Highland Drive, Lakeland, FL 33813 | 2016-06-27 |
| 1417317389 | Eye Specialists of Mid-florida, Pa | Ophthalmology | 2004 Cr 540 A, Lakeland, FL 33813 | 2016-03-04 |
| 1609234905 | Care and Life LLC | In Home Supportive Care | 6526 Fox Tree Lane, Lakeland, FL 33813 | 2016-02-02 |
| 1558731158 | Lori Ann Smith | Nurse Practitioner | 6030 S. Florida Ave, Suite 110, Lakeland, FL 33813 | 2015-09-25 |
| 1891182143 | Advanced Integrated Care Organization, LLC | Health Maintenance Organization | 5423 S. Florida Ave, Lakeland, FL 33813 | 2015-04-23 |
| 1902292352 | Central Health Associates | Internal Medicine | 4925 Old Rd 37, Lakeland, FL 33813 | 2015-04-13 |
| 1134542848 | Gledia Lovering | Dietitian, Registered | 6420 Highlands In The Woods St, Lakeland, FL 33813 | 2014-01-31 |
| 1134556368 | Billy Rogers | Nurse Anesthetist, Certified Registered | 4513 Orangewood Loop W., Lakeland, FL 33813 | 2013-10-02 |
| Find all providers in zip 33813 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811517840 | Kecia Howell | General Practice | 7433 Us Highway 98 N, Lakeland, FL 33809-2140 | 2020-04-20 |
| 1114393469 | Lakeland Regional Health Systems, Inc. | General Practice | 811 S Lakeside Ave, Lakeland, FL 33815-4771 | 2015-08-20 |
| 1700213972 | Wendell O Blake Md Pa | General Practice | 505 Martin Luther King Jr Avenue, Suite 2, Lakeland, FL 33815-1527 | 2013-10-03 |
| 1649572249 | Lysmar Carrion Dinguis | General Practice | 4725 Us Highway 98 S Ste 101, Lakeland, FL 33812-4334 | 2010-12-02 |
| 1891945580 | Luis J. Velazquez Vicente | General Practice | 4120 Us Highway 98 N, Suite 200, Lakeland, FL 33809-3854 | 2008-09-30 |
| 1225227051 | Lenny Tua Mendez | General Practice | 4725 Us Highway 98 S Ste 102, Lakeland, FL 33812-4334 | 2007-10-17 |
| 1841344454 | Evans Salomon Mercier | General Practice | 5020 Williamstown Blvd, Lakeland, FL 33810-3707 | 2007-01-22 |
| 1174690358 | Prudencio P Aqui | General Practice | 2133 S Combee Rd, Sterling Square, Lakeland, FL 33801 | 2006-11-30 |
| 1225134745 | Esther Echevarria | General Practice | 3810 S Florida Ave, Lakeland, FL 33813-1105 | 2006-09-15 |
| 1164539870 | Luis Garcia Rivera | General Practice | 5425 S Florida Ave, Lakeland, FL 33813 | 2006-08-25 |
| Find all providers in LAKELAND | ||||
Please comment or provide details below to improve the information on DR. MARIO THELIARD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.