Individual
DR. MARK D MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4680 MILLENIA PLAZA WAY, ORLANDO, FL 32839-2434
(407) 896-4440
(407) 896-4410
Mailing address
PO BOX 540929, ORLANDO, FL 32854-0929
(407) 896-4440
(407) 896-4410
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME71478
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263875400
—
FL
Enumeration date
08/03/2006
Last updated
06/02/2009
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