Individual
MARK PASQUARIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4606 CLYDE MORRIS BLVD STE 1D, PORT ORANGE, FL 32129-7453
(386) 492-2986
Mailing address
4606 CLYDE MORRIS BLVD STE 1D, PORT ORANGE, FL 32129-7453
(386) 492-2986
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
30840
FL
Other
Enumeration date
05/24/2021
Last updated
05/24/2021
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