1619926235 NPI number — EMCARE PHYSICIAN PROVIDERS, INC.

Table of content: DR. MARIO RICCARDO COLELLA D.O. (NPI 1336106277)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619926235 NPI number — EMCARE PHYSICIAN PROVIDERS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMCARE PHYSICIAN PROVIDERS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619926235
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 41579
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19101-1579
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-507-8874
Provider Business Mailing Address Fax Number:
727-507-3630

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 LEE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEHIGH ACRES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33936-4835
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-368-4410
Provider Business Practice Location Address Fax Number:
239-368-4420
Provider Enumeration Date:
05/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MURPHY
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE VICE PRESIDENT
Authorized Official Telephone Number:
214-712-2000

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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