Individual
DR. MARIO MARC PAESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6000 N FEDERAL HWY, FORT LAUDERDALE, FL 33308-2226
(954) 771-2551
Mailing address
6000 N FEDERAL HWY, FORT LAUDERDALE, FL 33308-2226
(954) 771-2551
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
OS20311
FL
208VP0014X
Interventional Pain Medicine Physician
Primary
OS20311
FL
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
270949204
NON-MEDICARE
FL
Enumeration date
06/13/2019
Last updated
09/06/2023
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