Individual
MARK A. DAICOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
601 7TH ST S STE 205, ST PETERSBURG, FL 33701-4748
(727) 893-6235
(727) 553-7422
Mailing address
601 7TH ST S STE 205, ST PETERSBURG, FL 33701-4748
(727) 893-6235
(727) 553-7422
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9112118
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125349000
—
FL
Enumeration date
06/05/2019
Last updated
01/14/2025
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