Organization
POURKESALI ENTERPRISES LLC
Active
Other names
Palm Coast Eye Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN M POURKESALI D.O (PRESIDENT)
(386) 246-6289
Entity
Organization
Contact information
Practice address
391 PALM COAST PKWY SW UNIT 2, PALM COAST, FL 32137-4766
(386) 246-6289
(386) 246-6389
Mailing address
391 PALM COAST PKWY SW UNIT 2, PALM COAST, FL 32137-4766
(386) 246-6289
(386) 246-6389
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
OS8658
FL
Other
Enumeration date
11/22/2013
Last updated
11/22/2013
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