Organization
MARK A. NOWACKI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A NOWACKI M.D (PHYSICIAN)
(727) 347-4158
Entity
Organization
Contact information
Practice address
7011 1ST AVE S, SAINT PETERSBURG, FL 33707-1203
(727) 347-4158
(727) 345-2260
Mailing address
7011 1ST AVE S, SAINT PETERSBURG, FL 33707-1203
(727) 347-4158
(727) 345-2260
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
ME60591
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372504900
—
FL
Enumeration date
03/03/2015
Last updated
04/04/2024
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