Dicarlo, Mark Kenneth

Dicarlo, Mark Kenneth is an individual health care provider with primary practice located at 3801 S Kanner Hwy Ste 200 , Stuart FL 34994-4801. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Dicarlo, Mark Kenneth can be contacted via phone (772) 219-4026.

Contact Information

Primary practice address
3801 S Kanner Hwy Ste 200 Stuart FL 34994-4801
Phone: (772) 219-4026
Fax: (772) 283-4919
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA3676 Florida

Profile Details

NPI number 1710902606
LBN Legal business name Dicarlo, Mark Kenneth
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2006
Last updated Oct 9th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710902606 NPPES
Florida MEDICAID 290524800

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