Individual
DR. MARK SUPINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-6910
Mailing address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-6910
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-116901
IL
207P00000X
Emergency Medicine Physician
Primary
ME116582
FL
Other
Enumeration date
04/23/2007
Last updated
01/29/2015
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