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Individual

DR. MARK EDMUND PESSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-1401
(321) 434-1667
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ME94760
FL
2086S0127X
Trauma Surgery Physician
Primary
ME94760
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
274458900
FL
01
31607X
MEDICARE HFPSI
FL
01
31607Y
MEDICARE
FL
Enumeration date
05/24/2005
Last updated
11/15/2023
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