# MARS MEDICAL GROUP P A

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215758107
- **Authorized official:** GREGORY S YOUTZ PA-C, FAAMM, ABAAHP (PRESIDENT, CEO)
- **Authorized official phone:** (813) 833-1355

## Contact information

- **Practice address:** 3816 W MORRISON AVE, TAMPA, FL 33629-4437
- **Practice address phone:** (813) 833-1355
- **Mailing address:** 2812 W ALLINE AVE, TAMPA, FL 33611-2806
- **Mailing address phone:** (813) 833-1355

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 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