Healthcare Provider Details

I. General information

NPI: 1508172735
Provider Name (Legal Business Name): DAVID M DRESDNER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 08/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1099 5TH AVE N 120
ST PETERSBURG FL
33705-1469
US

IV. Provider business mailing address

1099 5TH AVE N 120
ST PETERSBURG FL
33705-1469
US

V. Phone/Fax

Practice location:
  • Phone: 727-820-7714
  • Fax: 727-820-7755
Mailing address:
  • Phone: 727-820-7714
  • Fax: 727-820-7755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME34572
License Number StateFL

VIII. Authorized Official

Name: DR. DAVID MARK DRESDNER
Title or Position: PRESIDENT
Credential: MD
Phone: 727-820-7714