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General NPI Number Information
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NPI Number | 1902993934
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Entity Type | Organization
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Legal Business Name | MARY B TOMASELLI MD PA
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1283 N UNIVERSITY DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8314
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Country | US
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Telephone | 954-753-2683
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Fax | 954-753-2683
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Provider Business Mailing Address
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Address Line | 1283 N UNIVERSITY DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8314
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Country | US
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Telephone | 954-753-2683
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Fax | 954-753-2683
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARY BETH TOMASELLI
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Credential | MD
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Telephone | 954-753-2683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | ME49877
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME49877
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 172064
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License Number State | FL
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