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1518420264

NPI Code Detail

MEDICARE: DR. MARALEE BISONO MD

MEDICARE: DR. MARALEE BISONO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	ME155789	FL
2	208M00000X	Hospitalist Physician	ME155789	FL
3	208000000X	Pediatrics Physician	MD2025-1287	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518420264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARALEE BISONO MD

Provider Business Mailing Address
First Line	:	3100 E FLETCHER AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4613
Country	:	US
Telephone Number	:	813-467-4770
Fax Number	:	813-467-4243

Provider Business Practice Location Address
First Line	:	3100 E FLETCHER AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4613
Country	:	US
Telephone Number	:	813-467-4770
Fax Number	:	813-467-4243

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2019
Last Update Date	:	03/18/2026

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Directions to “ DR. MARALEE BISONO MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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