Individual
MARK C WITTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13330 USF LAUREL DR, TAMPA, FL 33612-6601
(813) 974-2201
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
37269
MN
207Y00000X
Otolaryngology Physician
Primary
ME133555
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
590223100
—
MN
01
—
6EBRJ
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/02/2005
Last updated
03/31/2021
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