Individual
DR. MARK S FARINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
15303 AMBERLY DR, SUITE E, TAMPA, FL 33647-2308
(813) 972-2929
(813) 977-1471
Mailing address
15303 AMBERLY DR, SUITE E, TAMPA, FL 33647-2308
(813) 972-2929
(813) 977-1471
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
13062
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64995
BLUE CROSS BLUE SHIELD
—
01
—
842353
UNITED CONCORDIA PROV. #
—
Enumeration date
03/12/2007
Last updated
07/08/2007
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