Individual
MR. MARK VINCENT WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2365 S TAMIAMI TRL, SARASOTA, FL 34239-3808
(941) 955-4325
(941) 955-4395
Mailing address
15 PARADISE PLZ, SUITE 300, SARASOTA, FL 34239-6905
(941) 955-4325
(941) 955-4395
Taxonomy
Speciality
Code
Description
License number
State
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
75251
FL
Other
Enumeration date
04/24/2007
Last updated
07/09/2007
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