Individual
DR. MARK A MOSTOVYCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1824 KING ST, STE 200, JACKSONVILLE, FL 32204-4735
(904) 384-3343
(904) 400-6671
Mailing address
1824 KING ST, STE 200, JACKSONVILLE, FL 32204-4735
(904) 384-3343
(904) 400-6671
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME70190
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250218600
—
FL
01
—
780000717
MEDICARE RAILROAD
—
Enumeration date
06/01/2005
Last updated
11/23/2022
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