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Individual

MARK F PATLOVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6716 NW 11TH PLACE, STE 200, GAINESVILLE, FL 32605-4215
(352) 331-9729
(352) 371-3372
Mailing address
6716 NW 11TH PLACE, STE 200, GAINESVILLE, FL 32605-4215
(352) 331-9729
(352) 331-0136

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME41975
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
067736100
FL
01
239216
AVMED
FL
01
270855
AVMED
FL
01
P00084967
RAILROAD MEDICARE
FL
01
P00451900
RAILROAD MEDICARE
FL
Enumeration date
05/24/2005
Last updated
11/01/2016
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