Organization
MARK W WHITE MD,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK WILLIAM WHITE M.D. (DOCTOR)
(386) 274-0250
Entity
Organization
Contact information
Practice address
1890 LPGA BLVD, SUITE 250, DAYTONA BEACH, FL 32117-7130
(386) 274-0250
(386) 274-0269
Mailing address
1890 LPGA BLVD, STE 250, DAYTONA BEACH, FL 32117-7131
(386) 274-0250
(386) 274-0269
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME75474
FL
Other
Enumeration date
11/13/2007
Last updated
11/13/2007
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