Healthcare Provider Details

I. General information

NPI: 1912835828
Provider Name (Legal Business Name): MARK A BERTEMATTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 N CAMPELL AVE ROOM 5304D
TUCSON AZ
85724-5058
US

IV. Provider business mailing address

8191 SW 143RD ST
PALMETTO BAY FL
33158-1568
US

V. Phone/Fax

Practice location:
  • Phone: 520-626-9540
  • Fax:
Mailing address:
  • Phone: 305-794-7888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR82456
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: