Individual
DR. MARK TOMBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4101 NW 4TH ST, SUITE 306, PLANTATION, FL 33317-2850
(954) 522-2979
(954) 903-0633
Mailing address
4101 NW 4TH ST, SUITE 306, PLANTATION, FL 33317-2850
(954) 522-2979
(954) 903-0633
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME39119
FL
207V00000X
Obstetrics & Gynecology Physician
Primary
ME39119
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252056700
—
FL
Enumeration date
08/23/2006
Last updated
02/05/2020
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