Healthcare Provider Details

I. General information

NPI: 1124263603
Provider Name (Legal Business Name): MARK JOSEPH MEYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2008
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 N FLAGLER DR STE 8300
WEST PALM BEACH FL
33401-3413
US

IV. Provider business mailing address

1411 N FLAGLER DR STE 8300
WEST PALM BEACH FL
33401-3413
US

V. Phone/Fax

Practice location:
  • Phone: 561-832-1234
  • Fax:
Mailing address:
  • Phone: 561-832-1234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberME127648
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME127648
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: