# POURKESALI ENTERPRISES LLC

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

## Provider details

- **NPI number:** 1972812394
- **Authorized official:** DR. MARTIN M POURKESALI D.O (OWNER)
- **Authorized official phone:** (386) 246-6289

## Contact information

- **Practice address:** 28 OFFICE PARK DR, PALM COAST, FL 32137-3808
- **Practice address phone:** (386) 246-6289
- **Mailing address:** 28 OFFICE PARK DR, PALM COAST, FL 32137-3808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | OS8658 | FL | Yes |

## Other

- **Enumeration date:** 10/04/2010
- **Last updated:** 10/04/2010