MEDICARE: MARK A FIRESTONE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	ME47978	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0750NSHR	OTHER	FL	NEIGHBORHOOD HEALTH
2	103541	OTHER	FL	AVMED

General Provider Information

NPI Number	:	1558349563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK A FIRESTONE M.D.

Provider Business Mailing Address
First Line	:	21110 BISCAYNE BLVD
Second Line	:	#312
City	:	AVENTURA
State	:	FL
Zip	:	33180-1227
Country	:	US
Telephone Number	:	305-933-3030
Fax Number	:	305-933-1436

Provider Business Practice Location Address
First Line	:	21110 BISCAYNE BLVD
Second Line	:	312
City	:	AVENTURA
State	:	FL
Zip	:	33180-1227
Country	:	US
Telephone Number	:	305-933-3030
Fax Number	:	305-933-1436

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	12/15/2025

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Directions to “ MARK A FIRESTONE M.D.” Practice Location

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