Payne, Mark Anthony

Payne, Mark Anthony is an individual health care provider with primary practice located at 921 W Lake Brantley Rd , Altamonte Springs FL 32714-2634. 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. Payne, Mark Anthony can be contacted via phone (321) 624-3102.

Contact Information

Primary practice address
921 W Lake Brantley Rd Altamonte Springs FL 32714-2634
Phone: (321) 624-3102
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA 2752 Florida

Profile Details

NPI number 1063506681
LBN Legal business name Payne, Mark Anthony
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Jun 25th, 2020 - about 5 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 1063506681 NPPES
Florida MEDICAID 292040900

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