Pessa, Mark Edmund
Pessa, Mark Edmund is an individual health care provider with primary practice located at 1350 Hickory St , Melbourne FL 32901-3224. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Trauma Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Trauma Surgery is his primary health care specialty. Pessa, Mark Edmund can be contacted via phone (321) 434-1401.Contact Information
Primary practice address
1350 Hickory St
Melbourne FL 32901-3224
Phone: (321) 434-1401
Fax: (321) 434-1667
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | ME94760 | Florida |
Allopathic & Osteopathic Physicians / Surgery | 208600000X | ME94760 | Florida |
Profile Details
NPI number | 1174526958 |
---|---|
LBN Legal business name | Pessa, Mark Edmund |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 24th, 2005 |
Last updated | Nov 15th, 2023 - about last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1174526958 | NPPES |
Florida | MEDICAID | 274458900 | |
Florida | Other | 31607X | |
Florida | Other | 31607Y |
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