| Pamela A Mark Llc | |
|
605 E Robinson St Suite 103 Orlando FL 32801-2040 | |
| (407) 697-7173 | |
| Not Available |
| Full Name | Pamela A Mark Llc |
|---|---|
| Speciality | Psychologist |
| Location | 605 E Robinson St, Orlando, Florida |
| Authorized Official Name and Position | Pamela A Mark (OWNER) |
| Authorized Official Contact | 4076977173 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pamela A Mark Llc 605 E Robinson St Suite 103 Orlando FL 32801-2040 Ph: (407) 697-7173 | Pamela A Mark Llc 605 E Robinson St Suite 103 Orlando FL 32801-2040 Ph: (407) 697-7173 |
| NPI Number | 1093999492 |
|---|---|
| Provider Enumeration Date | 12/20/2007 |
| Last Update Date | 02/07/2012 |
| Medicare PECOS PAC ID | 0446329437 |
|---|---|
| Medicare Enrollment ID | O20080516000239 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093999492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY6747 (Florida) | Primary |
| Provider Name | Pamela A Mark |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679696496 PECOS PAC ID: 2668487935 Enrollment ID: I20060208000618 |
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