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Individual

DR. MARK ALLEN EBERBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
14012 US HIGHWAY 19, HUDSON, FL 34667-1165
(727) 868-4490
(727) 869-7085
Mailing address
14012 US HIGHWAY 19, HUDSON, FL 34667-1165
(727) 868-4490
(727) 869-7085

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0048142
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
07923
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/16/2005
Last updated
03/16/2009
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