# MARK AND KAMBOUR MD PA

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

## Provider details

- **NPI number:** 1447536289
- **Authorized official:** ANA VICIANA MD (DIRECTOR)
- **Authorized official phone:** (305) 503-6320

## Contact information

- **Practice address:** 4665 PONCE DE LEON BLVD, CORAL GABLES, FL 33146-2101
- **Practice address phone:** (305) 503-5610
- **Mailing address:** PO BOX 100914, ATLANTA, GA 30384-0914

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | ME60651 | FL | Yes |

## Other

- **Enumeration date:** 10/25/2011
- **Last updated:** 10/25/2011