Organization
HEART GROUP PA
Active
Organization
HEART GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK B. BARETTELLA M.D. (PRESIDENT)
(386) 257-6644
Entity
Organization
Contact information
Practice address
311 N CLYDE MORRIS BLVD, SUITE 310, DAYTONA BEACH, FL 32114-2781
(386) 257-6644
Mailing address
PO BOX 9254, DAYTONA BEACH, FL 32120-9254
(386) 290-7886
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Enumeration date
05/17/2006
Last updated
02/11/2025
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