Look up the most recent NPI and PECOS records

Mark T O'Connell

Internal Medicine

Allopathic & Osteopathic Physicians

1611 NW 12th Ave, Box 016960 M851, Miami, FL 33136-1005

PECOS Enrollment

Based on the most recent information from CMS, provider Mark T O'Connell does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1093747115
Provider Type
Individual
Full Name
O'Connell, Mark T
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
7/7/2006
Last Updated
1/28/2013

Contact Information

Practice Location

1611 NW 12th Ave, Box 016960 M851, Miami, FL 33136-1005

(305) 585-1111

(305) 243-8470

Mailing Location

1500 NW 12th Ave, Jmt-East 1007, Miami, FL 33136-1051

(305) 243-4664

(305) 243-9927

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License ME34709 Florida

Provider Identifiers

ID	Description	Issuer
ID 0655597-00	Description Medicaid	Issuer Unlisted Florida

Mark T O'Connell

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Graff, Erica Loren

Avallone, Stephen V

Berbel Caban, Ana Beatriz

Bowen, Mikayla

Sosa, Glenda

Harlamova, Oxana

Fernandez-Nosti, Yanelys R

Vuong, Loan

Haff, Stephen

Garcia, Chelsea Marie