Healthcare Provider Details

I. General information

NPI: 1861491276
Provider Name (Legal Business Name): MARK STEVEN DRESNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8045 SPYGLASS HILL ROAD SUITE 105
VIERA FL
32940-7984
US

IV. Provider business mailing address

8045 SPYGLASS HILL ROAD SUITE 105
VIERA FL
32940-7984
US

V. Phone/Fax

Practice location:
  • Phone: 321-253-1919
  • Fax:
Mailing address:
  • Phone: 321-253-1919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME55925
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: