Individual
DR. MARK EDWARD PANNA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, DIVISION OF CARDIOLOGY, 4TH FLOOR, GAINESVILLE, FL 32610-3003
(352) 273-9079
(352) 273-8889
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 273-9079
(352) 273-8889
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME103664
FL
207RC0000X
Cardiovascular Disease Physician
ME103664
FL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
ME103664
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002587700
—
FL
05
—
101366697
—
PA
Enumeration date
05/19/2006
Last updated
03/07/2014
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