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General NPI Number Information
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NPI Number | 1174449110
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Entity Type | Individual
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Provider Name | MARIO ANDRES VIGIL RN
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Gender | Male
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Dates
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Enumeration Date | 06/24/2026
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Last Update Date | 06/24/2026
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Provider Practice Location Address
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Address Line | 300 PINELLAS ST
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City | CLEARWATER
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State | FL
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Zip | 33756-3804
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Country | US
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Telephone | 727-900-1669
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Fax |
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Provider Business Mailing Address
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Address Line | 1735 PAMELIA DR
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City | CLEARWATER
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State | FL
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Zip | 33755-2147
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Country | US
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Telephone | 727-900-1669
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 9438364
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License Number State | FL
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