Individual
MR. MARTIN M POURKESALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
28 OFFICE PARK DRIVE, PALM COAST, FL 32137
(386) 246-6289
(386) 246-6389
Mailing address
28 OFFICE PARK DRIVE, PALM COAST, FL 32137
(386) 246-6289
(386) 246-6389
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0S8658
FL
208600000X
Surgery Physician
0S8658
FL
Other
Enumeration date
05/08/2006
Last updated
01/11/2008
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