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Individual

MARK PAUL PRESTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., J.D.

Contact information

Practice address
122 4TH AVE, SUITE 100, INDIALANTIC, FL 32903-3112
(321) 409-0667
(321) 409-0668
Mailing address
122 4TH AVE, SUITE 100, INDIALANTIC, FL 32903-3112
(321) 409-0667
(321) 409-0668

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
172699-01
NY
2085R0202X
Diagnostic Radiology Physician
Primary
ME72678
FL

Other

Enumeration date
11/30/2005
Last updated
02/05/2024
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