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Organization
MARS MEDICAL GROUP P A
Active
Organization
MARS MEDICAL GROUP P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY S YOUTZ PA-C, FAAMM, ABAAHP (PRESIDENT, CEO)
(813) 833-1355
Entity
Organization
Contact information
Practice address
3816 W MORRISON AVE, TAMPA, FL 33629-4437
(813) 833-1355
Mailing address
2812 W ALLINE AVE, TAMPA, FL 33611-2806
(813) 833-1355
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
261QP3300X
Pain Clinic/Center
—
NULL
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/23/2024
Last updated
11/05/2024
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