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:
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Health care specialties

SpecialtyCodeLicense #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 3 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 1174526958 NPPES
Florida MEDICAID 274458900
Florida Other 31607X
Florida Other 31607Y

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