Provider Demographics
NPI:1194747063
Name:DE PINTO, MARIO J (MD)
Entity type:Individual
Prefix:
First Name:MARIO
Middle Name:J
Last Name:DE PINTO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:MARIO
Other - Middle Name:J
Other - Last Name:DEPINTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7091 SADDLE CREEK LN
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34241-9791
Mailing Address - Country:US
Mailing Address - Phone:941-586-5872
Mailing Address - Fax:
Practice Address - Street 1:7091 SADDLE CREEK LN
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34241-9791
Practice Address - Country:US
Practice Address - Phone:941-586-5872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84930207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL62915OtherBCBS
FLH27957Medicare UPIN
FL62915BMedicare ID - Type Unspecified