Individual
MARC C. PEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
602 S MACDILL AVE, TAMPA, FL 33609-4614
(813) 875-6373
(813) 876-0960
Mailing address
602 S MACDILL AVE, TAMPA, FL 33609-4614
(813) 875-6373
(813) 876-0960
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME96228
FL
207W00000X
Ophthalmology Physician
TRN6699
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278603600
—
FL
Enumeration date
10/17/2006
Last updated
12/22/2011
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