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Individual

DR. MARK ANTHONY ROSANOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1478 HIGHLAND AVE STE A, MELBOURNE, FL 32935-6501
(321) 242-2026
(321) 242-2423
Mailing address
306 SCHOOL RD, INDIAN HARBOUR BEACH, FL 32937-3635

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036-067273
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001634901
BLUE CROSS BLUE SHIELD OF ILLINOIS
01
31602264
BLUE CROSS BLUE SHIELD OF ILLINOIS
IL
Enumeration date
07/28/2005
Last updated
04/19/2026
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